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Biomedical subjects

P Bonomi

Publications and source records attributed to P Bonomi.

At least 91 records · Page 5Linked to original sources
PubMed1985

Metastatic breast cancer: preliminary results with oral hormonal therapy.

Hormonal therapy is very effective in the treatment of patients with metastatic breast cancer. Response to various therapies leads to improved quality of life and prolonged survival. This clinical trial compared two commonly utilized additive hormonal agents, tamoxifen citrate and megestrol acetate (Megace). Preliminary data indicate equal efficacy and equal toxicity of these two hormones and suggests that both are suitable for first-line hormonal treatment of stage IV breast cancer.

Administration, Oral↗
PubMed1985

Megestrol acetate used as primary hormonal therapy in stage D prostatic cancer.

The majority of patients with advanced prostatic cancer respond either to castration or estrogen therapy. In an attempt to identify an alternative hormonal therapy, 25 symptomatic stage D prostate cancer patients were treated with megestrol acetate as initial hormonal therapy. Thirty-three patients were evaluable for response as defined by the National Prostatic Cancer Project criteria. Partial remission was observed in 11 patients and stable disease in 5, with an overall response rate of 70%. The projected median duration of response and survival were 10 and 20 months, respectively. Weight gain was common, but only two patients showed evidence of fluid retention. Gynecomastia, thromboembolic episodes, and gastrointestinal side effects were not observed in this group of patients, though two patients had increased pain shortly after therapy was initiated. Thus, in advanced prostatic cancer, megestrol acetate is effective primary therapy with minimal side effects.

Aged↗
PubMed1985

Primary hormonal therapy of advanced breast cancer with megestrol acetate: predictive value of estrogen receptor and progesterone receptor levels.

Estrogen (ER) and progesterone receptor (PR) levels in human breast cancer have been shown to have value in predicting response to a variety of hormonal therapies. However, the relationships between steroid receptor levels and tumor response and survival in patients treated with progestational agents for primary hormonal therapy have not been clearly defined. Forty-three advanced breast cancer patients, whose tumors had been assayed for ER and PR were treated with megestrol acetate as initial hormonal therapy. Twenty-five patients had ER and PR levels greater than 10 femtomole/mg cytosol protein, and the median ER and PR levels for the entire group were 114 fmol/mg and 100 fmol/mg, respectively. The overall response rate (complete and partial) was 46%, with a median duration of response of 66 weeks. Seventy percent of patients whose ER and PR were greater than 10 fmol/mg responded: Step-wise discriminant analysis showed that ER and PR were significantly related to response and that PR was the best predictor of response (P = .0034). Similarly, both ER and PR were significantly related to survival (P = .0001 for PR and P = .021 for ER). These data indicate that megestrol acetate is effective primary hormonal therapy in advanced breast cancer patients, and that ER and PR levels were significantly related to response and to survival duration. PR proved to be the best predictor of response in this group of patients.

Aged↗
PubMed1985

Metastatic breast cancer from an occult primary provisionally identified by steroid receptor content and two-dimensional protein electrophoresis: some problems associated with the use of the latter technique.

Occult primary breast cancer in a patient presenting with undifferentiated metastatic adenocarcinoma in an inguinal lymph node was provisionally diagnosed by the steroid receptor content of its metastases and by the sclerotic pattern of osseous metastases. This diagnosis was supported by the presence of several proteins electrophoresed in 2 dimensions that may be common to other identified adenocarcinomas of the breast. These proteins appear to be absent from a representative adenocarcinoma of the ovary and of the uterus, at least at the level of sensitivity provided by the dye used to detect them. Some clinical implications for the use of two-dimensional protein electrophoresis in identifying undifferentiated cancers are considered.

Bone Marrow↗
PubMed1984

Renal failure from metastatic breast carcinoma reversed by radiotherapy and chemotherapy.

We treated a patient who had acute renal failure secondary to obstructive uropathy from metastatic breast carcinoma. Attempts at ureteral catheterization and nephrostomy failed. Bilateral ureteral irradiation was given, followed immediately by chemotherapy, with relief of obstruction and normalization of renal function. Nineteen months later, the patient died; at that time, her serum urea nitrogen and serum creatinine levels were normal.

Acute Kidney Injury↗
PubMed1984

Doxorubicin and cisplatin for recurrent or metastatic squamous cell carcinoma of the head and neck.

Thirty-six patients with recurrent or metastatic squamous cell carcinoma of the head and neck were treated with doxorubicin and cisplatin. The overall response rate (complete + partial) was 30%, with a median duration of response of 4 months. Median survival durations for responders and nonresponders were 15 and 4 months, respectively. Nausea, vomiting, and alopecia were common. Neither grade 4 myelosuppression nor irreversible renal failure was observed.

Adult↗
PubMed1983

Provisional "normograms" for identifying adenocarcinomas of the prostate or colon and hepatocellular carcinoma derived from their distribution of proteins separated by two-dimensional electrophoresis.

The distribution of proteins in samples from 8 prostate and 4 colon adenocarcinomas and 1 hepatoma was analyzed by 2-dimensional protein electrophoresis. Composite "normograms" based upon their distribution of proteins were developed from these patterns. Particular attention was paid to acidic proteins between pI 3.5 and 5.9. Of 161 proteins enumerated, 23 of the first 135 were present in prostate cancers, compared with 68 in colon cancer and 85 in the hepatoma. The 26 proteins denoted from nos. 135 to 161 were prostate associated, and none was evident in the colon or hepatoma samples. Twenty-seven prostate, 20 colon, and 48 liver cancer proteins were "unique" to each of the 3 cancers, respectively. The patterns of protein associated with each type of cancer were so dissimilar that with this technique no difficulty should be experienced in distinguishing these carcinomas originating from 3 different types of "stem" cells without obligatory recourse to microscopy.

Adenocarcinoma↗
PubMed1981

Treatment of stage D prostatic carcinoma with megestrol acetate.

Nine previously untreated patients with stage D prostatic carcinoma received megestrol acetate 40 mg orally three times daily. Responses included five partial regressions, two stabilizations, and two progressions. Duration of response ranged from 3+ to 33+ months, with a mean of 11.7 months and a median of 12 months. Three of five patients who had failed prior hormonal therapy remained objectively stable while receiving megestrol acetate. No gastrointestinal toxicity, gynecomastia, fluid retention, or thromboembolic complications were observed during treatment. Weight gain of 5 to 51 pounds occurred in seven of 14 patients.

Aged↗
PubMed1979

Management of carcinoid syndrome.

Two patients who had severe carcinoid syndrome are presented. In one patient prednisone relieved symptoms for 20 months, and in the second patient chemotherapy appears to have precipitated fatal carcinoid crisis. Changes in mentation, increased frequency and intensity of flushing, and hypotension indicate increased risk of a chemotherapy induced carcinoid crisis. Since prednisone may produce relatively long control of carcinoid syndrome, it should be tried before chemotherapy in patients who have increased risk of carcinoid crisis. If chemotherapy is given, doses should be decreased by 50%, and patients should be followed closely.

Antineoplastic Agents↗
PubMedDate not supplied

Comparison of several model-based methods for analysing incomplete quality of life data in cancer clinical trials.

This paper considers five methods of analysis of longitudinal assessment of health related quality of life (QOL) in two clinical trials of cancer therapy. The primary difference in the two trials is the proportion of participants who experience disease progression or death during the period of QOL assessments. The sensitivity of estimation of parameters and hypothesis tests to the potential bias as a consequence of the assumptions of missing completely at random (MCAR), missing at random (MAR) and non-ignorable mechanisms are examined. The methods include complete case analysis (MCAR), mixed-effects models (MAR), a joint mixed-effects and survival model and a pattern-mixture model. Complete case analysis overestimated QOL in both trials. In the adjuvant breast cancer trial, with 15 per cent disease progression, estimates were consistent across the remaining four methods. In the advanced non-small-cell lung cancer trial, with 35 per cent mortality, estimates were sensitive to the missing data assumptions and methods of analysis.

Breast Neoplasms↗