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Biomedical subjects

S Biran

Publications and source records attributed to S Biran.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

Chemotherapy induction, consolidation radiotherapy and maintenance alternating chemotherapy in small cell carcinoma of the lung.

Forty-four evaluable, previously untreated patients with small cell lung cancer were treated with two courses of induction chemotherapy consisting of POCC. Subsequently, all limited-disease patients and extensive-disease patients in CR received 4,000 to 5,000 cGy irradiation over 4 to 5 weeks (or the equivalent) to the primary tumor, mediastinum and supraclavicular areas and 3,000 cGy prophylactic cranial irradiation during 2 weeks. All patients received maintenance chemotherapy for a full year after CR or until disease progression. Eleven continued POCC while 33 received vinblastine, cyclophosphamide, and either adriamycin or methotrexate on an alternating schedule (VCMA). For the 20 limited-disease patients, the CR rate was 70% and the PR rate was 20%. Median survival was 22 months, local control was 62%, 2-year DFS was 35% and 3-year DFS was 20%. Of the 24 extensive-disease patients only 21% achieved CR and 54% achieved PR. Median survival was only 8 months and there were no disease-free survivors at 2 years. Toxicity was moderate with nausea and vomiting in all patients, and there were two deaths from myelosuppression in the group that received POCC maintenance therapy; there were no drug-related deaths in the VCMA group. Since these results are similar to those obtained with simpler regimes, we cannot recommend our regimen for the treatment of small cell lung cancer. The optimal treatment for this disease has yet to be elucidated.

Adult↗
PubMedDate not supplied

The effects of ionizing irradiation on production of thromboxane and prostacyclin by the isolated perfused rat kidney.

Exposure to whole body radiation is associated with prompt changes in urinary excretion of prostaglandins. We investigated the separate effects of radiation on rat kidney capillary and tubular system prostaglandin synthesis. Animals were irradiated to the left kidney area with a single dose of 15 Gy. One week later the rats were anesthesized, the renal artery, vein and ureter of the left kidney cannulated, and the kidney removed and perfused with Krebs-Henseleit physiological buffer at a rate of 10-12 ml/min. Effluent fluids were collected separately from the renal vein and from the ureter of irradiated and control (operated sham-irradiated animals) and were assayed by radioimmunoassays for thromboxane A2 (TXB2) and prostacyclin (6 keto PGF1 alpha). Histological examination of the irradiated kidneys showed no significant changes, and electron microscopy revealed minimal interstitial edema. In contrast to these minimal changes, TXB2 assays showed a significant increase both in the venous and ureter effluents. Following stimulation with angiotensin II in the perfusate, a further significant increase in TXB2 production was observed both by the capillary and the tubular systems. With 6 Keto PGF1 a slightly different response was seen. The basal production was increased only in the ureter effluent of the irradiated animals, while there were no changes in the release in the venous effluents. In parallel, radiation significantly increased the angiotensin II stimulated production capacity of prostacyclin by the tubular system. The response of the capillary system following irradiation may create imbalance between these two important substances and lead to the radiation effects in the renal tissue.

Animals↗
PubMedDate not supplied

Cyclophosphamide, adriamycin, DTIC and vincristine with methotrexate in the treatment of advanced soft tissue sarcomas.

Twenty-eight consecutive adult patients with locally advanced (inoperable) or metastatic soft tissue sarcomas were treated with a chemotherapy regimen (CADOM) including cyclophosphamide, ADR, and DTIC on Day 1 of each course, and vincristine with intermediate-dose methotrexate (200 mg/m2) on Day 15 followed by leucovorin rescue. Twenty-four of the patients were evaluable for response and toxicity. Three (13%) achieved a CR after chemotherapy and 6 (25%) a PR. Two of the PRs were converted to CR after surgical removal of residual tumor. All five patients achieving a CR are alive 12 to 30 months after beginning chemotherapy. Median survival of patients achieving a PR was 18 months and of patients achieving an MR was 7 months. Three of five patients with sarcomas arising from the female genitalia achieved a CR. No treatment-related deaths occurred. There were five instances of leukopenia and fever. Nausea and vomiting, and alopecia were common. Stomatitis, muscle cramps, paralytic ileus, and peripheral neuropathy were occasionally observed. The addition of methotrexate did not improve the response rate when compared with our previous CYV ADIC protocol.

Adult↗
PubMedDate not supplied

Combination chemotherapy in metastatic tumors of unknown origin. 5-Fluorouracil, adriamycin and mitomycin C for adenocarcinomas and adriamycin, vinblastine and mitomycin C for anaplastic carcinomas.

Twenty-nine evaluable patients with metastatic carcinomatosis in whom initial workup failed to reveal the primary site were entered into this trial. Patients with histological evidence of adenocarcinoma (n = 15) received FAM, while patients with anaplastic carcinomas (n = 14) were given AVM. Pretreatment characteristics were similar for the FAM- and AVM-treated patients with regard to age and sex, but 47% of patients on FAM had liver metastases as compared with 36% for the AVM group. Of the 14 patients on AVM, 1 (7%) achieved a complete response lasting 16 months, and 3 patients (22%) achieved a partial response for 10, 12 and 20 months, respectively. No patient on FAM reached a complete response, and only two patients (13%) showed a partial remission for 7+ and 24 months, respectively. The median survival for the AVM patients was 8.5 months, not significantly different from a median of 5 months for the FAM-treated group. AVM caused substantial myelotoxicity, resulting in five hospitalizations for leukopenia and fever; the FAM regimen was better tolerated with no episodes of leukopenic fever. AVM appears to be more effective than FAM in the treatment of carcinomas of unknown origin. A higher response rate was achieved with AVM, despite the fact that patients on this combination had undifferentiated carcinomas and a larger proportion of three or more metastatic sites (36 vs. 13% on FAM), and received a lower percent of the planned dose than did the FAM patients. Further clinical trials to fully establish the role of vinblastine in the treatment of metastatic carcinomatosis of unknown origin seem warranted.

Adenocarcinoma↗
PubMedDate not supplied

CA15-3 serum levels in breast cancer and other malignancies--correlation with clinical course.

Serum levels of the breast cancer-associated tumor marker CA15-3 were evaluated in three patient groups: breast, colorectal and ovarian cancer and in healthy subjects. Of 51 blood samples obtained from 31 patients with metastatic breast cancer (Stage IV disease), 98% had marker levels greater than 30 u/ml and 86% had levels greater than 50 u/ml. In contrast, of 49 samples from 42 patients with Stage I-II disease, 45% had levels greater than 30 u/ml but only 6% had levels greater than 50 u/ml (mean 29.5 +/- 18 u/ml). The mean level of the CA15-3 antigen in patients with Stage IV breast cancer and responding to therapy was 79.8 +/- 27 u/ml, while the mean level in patients not responding to therapy was 134 +/- 66 u/ml (P less than 0.02). The mean serial changes in CA15-3 levels for those responding to therapy was -28.4% while the mean change for those not responding to therapy was +44%. The mean marker level for 26 patients with colorectal carcinoma was 29.8 +/- 29 u/ml; 23% of these patients had levels greater than 30 u/ml and 7% had levels greater than 50 u/ml. No substantial difference was seen in those with active compared with nonactive colorectal carcinoma. The mean marker level for 14 patients with active ovarian carcinoma was 83 +/- 62 u/ml. Of these patients, 78% had CA15-3 levels greater than 30 u/ml and 50% had levels greater than 50 u/ml. All healthy subjects (n = 22) had marker levels less than 30 u/ml. We compared CA15-3 and CEA blood levels in the same patient population; 86% of patients with metastatic breast cancer (Stage IV disease) had CA15-3 levels greater than 50 u/ml while only 72% of these patients had CEA levels greater than 5 ng/ml. These findings suggest that the CA15-3 assay reflects the clinical course of patients with advanced breast cancer and may be superior to CEA as a monitor of therapeutic efficacy.

Antigens, Tumor-Associated, Carbohydrate↗
PubMedDate not supplied

Prognostic factors affecting treatment results with combination chemotherapy in metastatic breast cancer.

Seventy five patients suffering from metastatic breast cancer previously unexposed to chemotherapy were treated with Cyclophosphamide, Methotrexate and 5-fluorouracil (CMF) upon diagnosis of their first relapse. Dose Level I (85% or more of the planned dose) was given to 14 patients (19%); Dose Level II (66% to 84% of the planned dose) to 29 patients (39%); and Dose Level III (65% or less of the planned dose) to 32 patients (42%). Before initiation of treatment, 41 patients (55%) had a good performance status (PS greater than or equal to 80%) and 34 patients (45%) had a poor performance status (PS less than 80%) according to the Karnofsky scale. The overall response rate was 44%, including 17% complete responses. There was no significant correlation between response rates and the dose levels of chemotherapy. However, patients with a good performance status had a higher response rate (61%) compared with patients with a poor performance status (25%; p = 0.0025). The actuarial 3 year survival according to dose levels of CMF was 15%, 41% and 36% for Dose Levels I, II, and III, respectively (p = 0.34), but was 52% for patients with PS greater than or equal to 80% versus 14% for patients with PS less than 80% (p = 0.0001). These data indicate that the general condition of the patient at the time of initiation of CMF chemotherapy, as reflected by the performance status, may be of greater significance for the prediction of the ultimate treatment outcome rather than the total amount of chemotherapy delivered per se.

Adult↗
PubMedDate not supplied

Aminoglutethimide as second line endocrine therapy in advanced breast cancer.

Eighty five patients suffering from metastatic breast cancer, whose disease progressed on hormonal therapy with tamoxifen, were treated with aminoglutethimide. The overall objective response rate was 33%, with a median duration of response of 8 months. Even patients who failed to respond to tamoxifen responded to aminoglutethimide. Objective response was achieved in all metastatic sites, except for lung. Subjective improvement was observed in 75% of the patients. In spite of the fact that initial toxicity was high (70%), side effects of aminoglutethimide were transient, and treatment had to be discontinued in only 4 patients. The results of this trial indicate that aminoglutethimide is an important addition for the treatment of metastatic breast cancer, especially in patients with positive hormone receptors.

Adult↗
PubMedDate not supplied

Familial nephritis.

Explore the source record for details and available documents.

Adolescent↗
PubMedDate not supplied

First, second and third line chemotherapy programs in metastatic breast carcinoma.

The experience with three different chemotherapeutic regimes used as first, second and third line treatment in metastatic breast carcinoma is reported. Cyclophosphamide, Methotrexate and 5-fluorouracil (CMF) were given to 117 previously untreated patients. Objective remission was seen in 49%, including 8% with complete remission (CR) for a median duration of response lasting 16 mo. CMF plus vincristine and prednisone (CMFVP) was given to 88 patients who had failed on CMF therapy. Twenty-three percent achieved an objective remission, complete (CR) in 6% and partial (PR) in 17%, and another 28% improved I), giving a Cr+PR+I rate of 51% with remission lasting a median of six months. Finally, 23 patients who failed on CMFVP chemotherapy were given adriamycin, bleomycin, vinblastine and dimethyl-triazo-imidazole-carboxamide (ABVD) as tertiary chemotherapy; 17% achieved PR and 13% improved for a median period of nine and seven months, respectively, with a median survival of eight months for this subgroup--compared with only 4.5 months for 12 patients who progressed on this third line treatment. All three regimens were relatively well tolerated. Six patients, however, developed a fatal septic shock while leukopenic on CMFVP. Cardiac and pulmonary toxicity have not been observed. The sequential administration of chemotherapeutic regimens as reported here offers the opportunity for repeated remission in patients with active metastatic breast carcinoma and results in prolonged survival for responders.

Adult↗
PubMedDate not supplied

Maintenance of prolactin receptors in human breast cancer.

Breast tissue specimens of 110 women with various stages of breast cancer were tested in vitro to determine their specific binding sites for human prolactin. In contrast to the case of steroid receptors, binding sites for prolactin were found in the vast majority of breast cancer tissue. Distribution profiles giving amount of prolactin receptor and their affinity coefficients were found to be similar in the tissues of women whose ages, hormonal status, or stage of breast cancer varied. These findings show that in contrast to steroid receptors, human breast cancer tissue maintains binding sites for prolactin. The findings also indicate that there may be a higher dependency of breast cancer on prolactin than on steroids. Clinical trials must be carried out to determine the role of "positive" prolactin receptors in prognosis and prediction of response to future hormone therapy.

Adult↗