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Biomedical subjects

S Chaitchik

Publications and source records attributed to S Chaitchik.

At least 91 records · Page 5Linked to original sources
PubMed1992

Our experience with interferon alpha: metastatic malignant melanoma.

Interferon-alpha and dacarbazine combination is a milestone in the treatment of metastatic malignant melanoma. Objective response rate ranged from 3% to 25%. Our phase II study included 34 patients; the overall response was 29.4%. Median time of survival of the responders was significantly longer than that of the nonresponders. Nine of the 34 patients had previously progressed on interleukin-2 (IL-2) and dacarbazine treatment, or had been withdrawn because of unacceptable toxicity. Two patients (22.2%) achieved partial responses. There seemed to be no cross-resistance between the two biologic response modifiers. Successful treatment of melanoma patients by interferon resulted in complete disappearance of all extracerebral lesions, but left the brain vulnerable to involvement by metastases, and was frequently a site of relapse. Brain irradiation is suggested by several investigators to prevent cerebral involvement. Ongoing protocols are an adjuvant treatment for high-risk patients and combination of interferon-alpha, IL-2, dacarbazine and cisplatinum for metastatic melanoma after failure of interferon-dacarbazine regimen.

Adolescent↗
PubMed1992

Metastases to skeletal muscles and interferon treatment.

Blood-borne metastases to a skeletal muscle are rare and may originate in various primary tumors. Recurrent solitary metastasis of renal cell carcinoma, and metastatic lesion as part of disseminated malignant melanoma in skeletal muscles are reported in two patients. In both cases interferon treatment with or without chemotherapy failed in arresting the disease.

Aged↗
PubMed1992

Malignant melanoma of the mucous membranes.

Primary malignant melanoma occurring in mucous membranes is uncommon. Of 410 patients with malignant melanoma, 14 (3.4%) had their primary tumour located in mucosal membranes. Five of the tumours were in the mucosal lining of the head and neck, five in the gastrointestinal tract mucosa and four in the female genitalia. Eight of the tumours were ulcerated, necrotic and deeply invasive. The most common histological subtype was acral lentiginous melanoma. Surgical resection of the primary tumour was performed in 10 patients. In the other four, surgery was not feasible, and they were treated by irradiation and immunotherapy. Six patients underwent regional lymph node dissection. In four of them, regional metastases were found. Chemotherapy was given to seven patients for widespread metastases. Nine patients (64%) died of metastatic melanoma within 2 years. The remaining five patients are alive after 3 to 8 years. It appears that mucosal membrane melanoma is a distinct variant of the disease due to both its aggressive biological behaviour and its relative inaccessibility for surgical removal, and may therefore be classified separately.

Adult↗
PubMed1991

Interferon-related leukoencephalopathy in a patient with renal cell carcinoma.

A 75-year-old patient with metastatic renal cell carcinoma was treated with recombinant interferon alpha-C and thereafter developed a neurologic syndrome of dementia, ataxia, confusional state, loss of concentration ability and cortical blindness. CT scan findings were compatible with leukoencephalopathy, which is reported as being a toxic effect of interferon.

Aged↗
PubMed1991

Are malignant melanoma patients at higher risk for a second cancer?

This study tests whether malignant melanoma (MM) patients are at higher risk of having an unrelated second cancer by comparing the observed incidence of a second cancer in a given population of MM patients with the expected number in an age-matched and sex-matched group of healthy people followed for a similar period. The analysis was based on the person-years method in which the main consideration is the follow-up period after the diagnosis of MM. Of 370 patients with histologically confirmed MM, 27 (7.3%) had a second noncutaneous invasive cancer, diagnosed either simultaneously (within 6 months, five patients) or after the diagnosis of MM (22 patients). The follow-up period for the entire MM group was 1253 person-years, a period during which the expected number of cancer cases in the normal population, according to the Israel Cancer Registry, was 6.6. The observed-expected ratio or the relative risk (RR) was 4.1 (P less than 0.01). After excluding the five patients with simultaneous diagnosis of MM and a second cancer, analysis of the remaining 22 patients in whom MM definitely preceded the second cancer showed an RR of 3.3 (P less than 0.01). For the entire group, there were nine patients with breast cancer, five with head and neck cancer (two with thyroid and three with oral cavity cancer), five with gynecologic cancer (one with uterine and four with ovarian cancer), five myeloproliferative malignancies (one with lymphoma, three with chronic lymphocytic leukemia, and one with myeloma), three gastrointestinal carcinomas (two with colon and one with stomach cancer), and two soft tissue sarcomas. When the differential analysis according to gender and age was done, it was found that the RR was higher for women (5.5, P less than 0.01) than for men where the RR was 2.2 (P less than 0.05). Differential analysis for various age groups showed that the trend for second cancer was consistent in all age groups, with a slight increase in the younger ones. None of the variables of MM, such as location of the primary tumor, level of invasion, or stage, were predictive for a second cancer. Furthermore, the RR for a second cancer did not relate significantly with the treatment given to the MM patient. Concerning the type of second cancer, it was found that the RR was especially high for breast cancer--6.6. These data indicate that MM patients may be at higher risk for having a noncutaneous invasive cancer compared with the general population.

Adolescent↗
PubMed1991

Skin metastasis of ovarian cancer: report of three cases.

Three cases of skin metastases in patients with ovarian cancer are reported. The late onset of skin metastases in the course of the disease represents an advanced stage accompanied by intraperitoneal spread and has a poor prognosis. Diagnosis and differentiation from herpes zoster and other skin tumors were based on histologic examination. Palliation of symptoms and partial local response were achieved by electron beam irradiation.

Aged↗
PubMed1991

Pharmacokinetics of recombinant interferon alpha-C.

Recombinant interferon alpha-C (rIFN alpha-C, Interpharm), is a new type of alpha-interferon that has a specific activity of 1-2 x 10(9) units/mg protein. The pharmacokinetics of rIFN alpha-C were studied in 11 patients with metastatic renal-cell carcinoma. A total of 10 million units IFN alpha-C were injected intramuscularly and the serum level of IFN was evaluated up to 72 h post-administration. Measurable IFN concentrations appeared in the serum as early as 0.5 h, and levels peaked at 4-6 h (Cmax = 53.2 +/- 4.6 units/ml). Relatively high levels persisted for 24 h and declined thereafter with an apparent half-life of 3-4 h. The mean area under the serum-concentration curve (AUC) was 1,259 +/- 145 units h ml-1, indicating good bioavailability of the preparation from the intramuscular injection.

Aged↗
PubMed1991

The production of human monoclonal anti-MMTV antibodies by in vitro immunization with anti-idiotypic antibodies.

We have previously reported the production of a series of human monoclonal antibodies reacting with mouse mammary tumor viral antigens as well as the human counterpart HuMTV antigen. Against two of these antibodies (B11 and 4.6/6), anti-idiotypic antibodies were generated, which appeared to be the internal image of viral antigen. Vaccination with the anti-idiotypic antibodies induced in mice humoral and cellular immunity against both MMTV and HuMTV. The current study describes a novel method to produce human anti-MMTV antibodies derived monoclonal antibodies. Normal peripheral blood lymphocytes (PBLs) were immunized in vitro in the presence of IL-2, with rabbit anti-B11 antibodies bound to silica beads. Following in vitro immunization, the lymphocytes were fused with the UC-792-6 human lymphoblastoid cell line. Four human hybridomas were found to secrete human monoclonal antibodies which bound to MMTV and HuMTV. Three of the secreted antibodies were of the IgG class and one of the IgM class. The specificity of binding was confirmed by direct and competitive ELISA assays and by radioimmunoprecipitation. Our study demonstrates the ability to generate human monoclonal anti-viral antibodies by in vitro immunization, employing "internal image" anti-idiotypic antibodies. The method can be used to generate human antibodies, especially against pathogenic agents or ill-defined antigens.

Antibodies, Anti-Idiotypic↗
PubMed1991

Serial serum MCA measurements in the follow-up of breast cancer patients.

Mucin-like carcinoma-associated antigen (MCA) was serially assayed in 58 women with histologically proven breast cancer after their treatment for primary disease. MCA sensitivity and specificity were 87.5% and 76.9%, respectively, and the positive predictive value 82.4%. 10 patients had elevated MCA and no evidence of disease (NED) during their follow-up, of whom 4 finally developed overt metastases. The 4 had a mean (S.D.) MCA value of 46.48 (18.26) U/ml during the lead time, versus 18.76 (2.69) U/ml in the other 6, who are still at high risk for developing overt metastases. Raised levels of MCA in patients with NED create a dilemma of "treat" versus "wait and see". Early treatment of patients with serially uprising MCA levels should be evaluated in a prospective randomised study to assess its ability to prevent or delay the development of overt metastatic disease and influence survival.

Adult↗
PubMed1991

Induced versus spontaneous attendance of breast-screening tests by women.

Despite the availability of services and information, not enough women undergo breast-screening tests. A previous study showed that clinic attenders differ from nonattenders in emotions, personality, self-concept, neuroticism, psychosomatics, and health attitudes. Some of these resembled the cancer-prone personality. The present study was designed to test whether nonattenders have higher repression that supports denial and could be persuaded by positive inducements to undergo the tests. Other goals were to examine if the new sample replicates the former findings and if it differs from clinic attenders. The subjects were 210 spontaneous clinic attenders and 210 matched controls from the previous study and 46 positively induced women. They were administered questionnaires assessing emotions, personality, daydreaming, self-concept, neuroticism, somatic complaints, alexithymia, and health attitudes. The findings were that the induced sample scored higher on repressiveness, had more cancer-affected blood relatives, and responded favorably to the positive inducements. They differed from the controls in most of the variables the clinic attenders did but differed from the clinic attenders in 30% of the variables, manifesting more extreme correspondence to the cancer-prone personality. The findings indicate possibilities of drawing more individuals to undergo the tests by emphasizing the positive anxiety-reducing approach.

Adult↗
PubMed1991

Treatment of advanced colorectal cancer by 5-fluorouracil-leucovorin combination with or without allopurinol: a prospective randomized study.

5-Fluorouracil (5-FU) remains the most effective chemotherapeutic agent in the management of patients with metastatic colorectal cancer. Leucovorin enhances its efficacy, but also its toxicity. Cited data suggest modulation of 5-FU toxicity by high dose allopurinol. In a prospective randomized trial we assessed the ability of allopurinol in a conventional dose to modulate the toxicity of 5-FU-leucovorin combination without compromising its efficacy in 50 patients with advanced colorectal cancer. Twenty-seven patients were randomized for allopurinol but had no benefit in terms of response or reduced toxicity over the other 23. Survival of responders with colon cancer was longer than that of non-responders (p = 0.013). Although allopurinol failed to reduce 5-FU-leucovorin toxicity, it did not lower its expected efficacy.

Adult↗
PubMed1991

Does vinblastine add to the potency of alpha interferon in the treatment of renal cell carcinoma?

The combination of alpha interferon and vinblastine has been reported to yield a response rate of 30-40% in previously untreated patients with metastatic renal cell carcinoma. This combination was given to nine patients with advanced metastatic renal carcinoma after they failed or relapsed on alpha-interferon alone, to attempt to evaluate the role of vinblastine in this combination. Neither complete nor partial response was observed. Two patients had disease stabilization for two and seven months. Our preliminary results suggest that vinblastine did not add to the efficacy of interferon in this group of patients.

Aged↗
PubMed1990

Metastatic disease of the cavernous sinus: contribution of computed tomography and magnetic resonance imaging to diagnosis.

The clinical presentation of metastatic disease to the cavernous sinus includes ophthalmoplegia, pain and sensory deficit along the optic or maxillary branches of the trigeminal nerve. The role of a CT scan and magnetic resonance imaging in the diagnosis is discussed. It was found that magnetic resonance imaging is superior to CT scan in demonstrating the cavernous sinus and pontine borders, especially in lymphomatous involvement of these structures.

Adult↗
PubMed1990

Endobronchial metastasis of ovarian cancer. A case report.

An 83 years old woman with known ovarian carcinoma complained of dyspnea, dysphagia and hoarseness. Clinical and radiological investigations revealed a mediastinal metastasis involving and penetrating the right main bronchus. Palliation of dyspnea was achieved by laser therapy.

Adenocarcinoma, Papillary↗
PubMed1990

Recurrent solitary metastasis of renal cell carcinoma in skeletal muscles.

Metastatic carcinoma to skeletal muscle is uncommon and may originate from breast, colon, lung, pancreas and other sources. Recurrent solitary metastases of renal cell carcinoma in the biceps femori and gluteus muscles are described in a 69 year-old man. The tendency of metastases to occur merely in muscles could not be explained in our case. The relative immunity of muscle to the metastatic process should be further investigated.

Aged↗