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Biomedical subjects

P Alberto

Publications and source records attributed to P Alberto.

At least 109 records · Page 6Linked to original sources
PubMed1978

[Curability of malignant neoplasms: value and limitations of chemotherapy].

Cancer chemotherapy was purely palliative until the early sixties. Tumor cures have been since obtained, first in malignant trophoblastoma and Burkitt's lymphoma, and more recently in Hodgkin's disease, diffuse histiocytic lymphoma, acute lymphocytic leukemia in children, Wilms's tumor and osteosarcoma. Preliminary data are suggestive of tumor cures in testicular teratomas and, possibly, in small cell carcinoma of the lung. Five patients with trophoblastoma, Hodgkin's disease, melanoma, chronic myelocytic leukemia and anaplastic carcinoma of the lung are briefly presented, all without evidence of tumor relapse 3 years or more after chemotherapy. Theoretical bases for improvement of the curative effect of cancer chemotherapy are discussed, including the development of new agents, and new pharmacological problems concerning drug interactions, complexes of drugs with macromolecules or immunoglobulins and liposomes are considered.

Adult↗
PubMed1978

[Simultaneous hormonal and drug therapy, compared to hormonal therapy, followed by chemotherapy, in the treatment of metastasizing breast neoplasms. Preliminary results of an ongoing study].

The preliminary results of a still ongoing phase III study in patients with previously untreated metastatic breast cancer are reported. 210 cases are already evaluable. In this study patients are randomized to hormonotherapy either concurrently with combination chemotherapy or alone, chemotherapy being delayed until the occurrence of tumor progression. In both groups patients are further randomly allocated to 3 chemotherapy programs. So far there appear to be differences between remission rates, but not with regard to survival course.

Antineoplastic Agents↗
PubMed1978

[Medical treatment of primary pulmonary neoplasms].

Primary cancer of the lung is the most frequent malignant tumor in Switzerland among males and its frequency is rapidly increasing among females. The rate of failure after curative treatment including surgery and/or radiotherapy is about 80%. A large proportion of lung tumors are already inoperable at the time of diagnosis, a fact which accounts for the importance of chemotherapy as a palliative treatment for lung cancer. Single drug chemotherapies are relatively ineffective, with an overall response rate of 20% and a response rate of up to 50% for small cell tumors. Combination chemotherapies attain a 50 to 90% response rate in small cell tumors while the rate of failure is 50% or more in other cell types. Published results of post-surgical adjuvant chemotherapy of lung cancer are equivocal, possibly due to unwanted differences in the selection of patients and in therapeutic schedule. It is still not demonstrated that adjuvant chemotherapy improves lung cancer treatment.

Cyclophosphamide↗
PubMed1978

[Therapeutic progress. Critical analysis of controled and non-controled clinical studies].

Methods used in the evaluation of therapeutic results in clinical oncology are criticized on the basis of recent examples of studies including the most-used antitumor agents. The need for random allocation of patients in comparative studies is underlined and the practical, statistical, and ethical limitations on randomization procedures are reviewed.

Ethics, Medical↗
PubMed1978

[Antiestrogens: a new endocrine treatment possibility in metastasizing breast neoplasms. Experiences of the Swiss Cooperative Cancer Study Group with tamoxifen].

The detection of specific hormone receptors in normal and tumor tissue has brought new insight into the mechanisms of action of hormones and anti-hormones. The Swiss Cooperative Cancer Study Group (SAKK) has evaluated the antitumor effect of the new antiestrogenic substance tamoxifen in metastatic breast cancer. 158 postmenopausal patients treated with 20 mg/d tamoxifen by mouth are evaluable at present time. Complete and good partial remissions were achieved in 39 patients (25%) largely with soft tissue but also lung and bone metastases. Tamoxifen was well tolerated and caused few serious complications such as thrombosis/pulmonary embolism and hypercalcemia. These results confirm already published experience with tamoxifen, which may replace the estrogens as the primary endocrine treatment in postmenopausal mammary carcinoma metastasizing to soft tissues, lung and bone.

Bone Neoplasms↗
PubMed1978

Initial clinical experience with a simultaneous combination of 2,4-diamino-5(3',4'-dichlorophenyl)-6-methylpyrimidine (DDMP) with folinic acid.

DDMP, a diaminopyrimidine folate antagonist, was given to 26 tumor patients in a dosage of 50 mg/m2 per week orally, simultaneously with 3 mg CF i.m. or i.v. The CF dose was increased to 30 mg in patients showing evidence of toxicity, and withdrawn in the absence of toxicity. The dose-limiting toxicity was seen in myelosuppression, particularly thrombopenia and skin rashes. At the 3 mg CF level, 18 out of 26 patients developed toxicity. No toxicity was seen at the 30 mg CF level in 11 patients. After cessation of CF, toxicity occurred in five out of seven patients. After the onset of toxicity, CF was added as a delayed rescue, in a dosage of 15 mg every 8 h or 30-60 mg daily. One patient died of sepsis with agranulocytosis. All other patients recovered from myelosuppression within 1 or 2 weeks. Objective responses were observed in seven patients, four of the ten with epidermoid cancer of the head and neck, two out of eight with epidermoid cancer of the lung, and one out of three with melanoma.

Adult↗
PubMed1978

ARA-C analogs.

Ara-C, a phase-specific antitumor agent, is rapidly deactivated by the enzyme cytidine deaminase. A prolongation of the biological activity of ara-C can be achieved either by the concomitant use of a cytidine deaminase inhibitor or by the development of ara-C derivatives with increased resistance to deamination and a longer half-life in serum. Among such derivatives are cyclocytidine (cyclo-C), anhydro-ara-5-fluorocytidine (AAFC) and the N4-acyl-derivatives. AAFC has been recently shown to be active in human leukemias and in solid tumors of the digestive tract. The tolerance to AAFC is sufficient for clinical use, and AAFC does not produce parotid pains and hypotension, characteristic side effects of cyclo-C. The main toxicity consists of myelodepression, nausea and vomiting. The schedule dependence of AAFC is far less pronounced than for ara-C, so that a weekly application by rapid i.v. injection of 30-40 mg/kg (1,200-1,500 mg/m2) reaches the level of activity with acceptable toxicity. AAFC seems to be as active as ara-C in acute leukemias and is probably active too in malignant lymphomas. In a large phase II trial of the EORTC on selected solid tumor types, AAFC showed a significant activity in GI tract adenocarcinomas with 2 responses/3 evaluable in pancreas, 7/14 in stomach and 2/32 in colorectal tumors (4/30). Hints of activity were also detected in breast cancer (1/17) and anaplastic small cell carcinoma of the lung (1/9). No responses were obtained in 27 patients with epidermoid carcinoma of the lung. These results confirm that ara-C, or newer ara-C analogs, are potentially active in various solid tumor types, and suggest that an extensive further clinical study of such new derivatives is warranted.

Clinical Trials as Topic↗
PubMed1977

[Retrospective study of 99 cases of ovarian carcinoma, stages I to IV].

A retrospective study on the survival of 99 patients with ovarian carcinoma stages I-IV has been conducted. A bad prognosis for early stages is emphasized. 38 of the 64 patients treated by chemotherapy presented an objective therapeutic response: 24 cases showed complete or partial remission of a duration between 4 to 26 months, while 14 cases showed no change or progressive disease. The effects of chemotherapy on survival have been statistically analyzed for these 38 cases and have shown a longer survival for responders. These results suggest that the use of chemotherapy as an adjuvant to surgery in ovarian cancer deserves further investigation.

Aged↗
PubMed1977

[Therapeutic results and prognostic factors in acute lymphatic leukemia in the adult].

Induction chemotherapy consisting of vincristine, prednisone and L-asparaginase was given to 22 adult patients with acute lymphatic leukemia. Manintenance treatment consisted of methotrexate, 6-mercaptopurine, prednisone and vincristine. Of the 22 patients treated, 14 had a complete remission. The median remission duration was 14 months and the median survival 20 months. 8 further patients were included in an attempt to determine the significance of prognostic factors, but none of the parameters studied influence the course of disease with statistical significance. In general, younger patients and those with lower leukocyte counts at the time of diagnosis seemed to fare better.

Adult↗
PubMed1977

[Combination chemotherapy in acute blast crisis of chronic myeloid leukaemia (author's transl)].

Sixteen patients in an acute blast crisis of chronic myeloid leukaemia (CML) were treated with a combination of vincristine, 6-mercaptopurine, hydroxyurea and prednisone. Only two of these patients had complete remission on this treatment, while four had partial remission. This experience, comparable to that reported by others, suggests that aggressive treatment in the terminal phase of CML is justified only as part of a prospective and well-controlled study.

Adolescent↗
PubMed1977

[Hydroxyproline in the diagnosis of bone metastases in breast cancer].

15 patients with breast cancer and proven bone metastases have been studied. Free serum and total urinary hydroxyproline were measured and the ratio (hydroxyproline/creatinine) - 100 in a morning urine specimen was calculated. The preliminary results show elevated free serum hydroxyproline in 8 of 15 patients; total urinary hydroxyproline in a 24-h collection and the ratio hydroxyproline/creatine in a morning urine specimen were elevated in all cases. These results agree with those of the literature. Further studies of free hydroxyproline and of the ratio hydroxyproline/ creatinine in a morning urine specimen in similar patients with provide more information on the possibility of using these measurements, alone or in combination, for the early detection or follow-up under therapy of bone metastases.

Adult↗
PubMed1977

[Effect of combined chemotherapy on the prognosis of Hodgkin's disease: retrospective study of 74 cases from 1959-1973].

In this retrospective study the effect of combined chemotherapy on survival of patients with Hodgkin's disease is investigated. Among 125 cases observed between 1959 and 1973, the survival, response rate and duration of remission of patients treated with single drugs are compared with the same parameters in those treated by polychemotherapy. Further, since the combined treatment schedule was introduced in our group in 1969, survival of patients treated before and after this date is likewise compared. 35% of patients in the single drug group survived for more than 2 years, against 69% in the polychemotherapy group. At 3-year survival, the corresponding values were 12% and 61% respectively. For patients treated before 1969, survival of 2 and 3 years represents 45% and 22%. For patients treated from 1969 to 1973, the corresponding values are 61% and 51%. Rates of complete response are 20% for single drug treatments and 70% for combined treatments. Analysis of the results suggests that these differences correspond to the therapeutic superiority of combined chemotherapy in the treatment of Hodgkin's disease and not to major discrepancies in prognostic factors among the patient groups compared.

Adolescent↗
PubMed1976

[The treatment of acute myelocytic leukemia during the first recurrence by means of a new cytostatic combination].

Fifteen patients with acute myeloic leukemia in the first relapse following initial therapy were treated with a combination of adriamycin, vincristine, 6-thioguanine and the new podophyllotoxin derivative VP 16-213. Complete remission was obtained in 3 cases and partial remission in 3 further patients. The combination was generally well tolerated. These preliminary results are compared with those available in the relatively meagre literature. The study is being continued.

Cytarabine↗
PubMed1976

[Simultaneous combination of adriamycin, bleomycin, cyclohexyl-chloroethyl nitrosourea with dimethyl-triazeno imidazole carboxamide in the treatment of Hodgkin's lymphoma].

Sixteen patients with Hodgkin's (10) and non-Hodgkin's (6) lymphoma were treated by the "ABCD scheme", which is a combination of adriamycin (25-30 mg/m2 day 1), bleomycin (15 mg day 1-5), CCNU (60 mg/m2 day 1) and DIC (90-100 mg/m2 day 1-5). 15 results are evaluable and included 5 complete remissions, 5 partial remissions, 2 stabilizations, 2 progressions and 1 early death (remission rate: 66%). 45 ABCD courses were given. 8 patients received more than one course (maximum 7 courses). Toxicity was tolerable and consisted mainly of myelodepression, nausea, vomiting and muco-cutaneous alterations. Two patients died following toxicity, one from myelosuppression and the other from interstitial pulmonary fibrosis. The results suggest that this combination can be useful where the usual chemotherapy combination fails.

Adult↗