Comprehensive cancer management--principles, benefits, problems.
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Biomedical subjects
Publications and source records attributed to S Tanneberger.
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The antineoplastic effectivity of VCMF was compared with the combined therapy CRM plus DBD in the mouse tumor systems L1210, 1142 A and Lewis lung carcinoma. Therapy of tumor-bearing mice was carried out by administering doses on the basis of LD 10 or with doses directly calculated from the clinical study CMEA 0102. In the most of all experiments VCMF was superior to the combination CRM plus DBD.
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The clinical staging has much lesser importance in non-Hodgkin-lymphomas than in Hodgkin-lymphomas. Much more important for prognosis and treatment is there the histopathological subtype. For this reason there are many international activities directed to new ways of the histological classification of non-Hodgkin-lymphomas. Without any doubt Rappaport's proposal is the clinically most used non-Hodgkin-classification but more and more also the proposal of Lennert becomes accepted by clinicians. The immunological approach seemed to be the most promising way to qualify the Non-Hodgkin-lymphoma classification and finally to individualize the management of this type of neoplasia.
Ascitic tumor cells from a female patient with a peritoneal carcinomatosis have been cultivated in vitro. The 25th in vitro passage of these cells were characterized by gowth curves. DNA-distribution patterns, chromosome patterns and drug sensitivity. Cells of the 25th in vitro passage were i.p. transplanted in nude mice. The 14th and 18th passage of ascitic cells and the 3rd passage of the solid tumor material grown in nude mice were compared with cells of the 25th in vitro passage. Changes in DNA-distribution patterns, chromosome patterns and drug sensitivity were observed: The G1/0-peak of the ascitic tumor cells (AP 14, AP 18) revealed a shift to the left. This is in coincidence with the chromosome number reduction found. Differences in sensitivity to Methotrexate and 5-Fluorouracil after transplantation in nude mice were observed. The possible reasons of instability of these biological properties are discussed.
The development of human tumors is accompanied very often by tumor-associated phenomena such as production of tumor-derived substances, production of certian substances in response to the tumor or immunological reactions. Up to now no of these phenomena can be used as a diagnostic cancer test but biological markers are increasingly used for monitoring progression and regression of human tumors. Basing on a number of own studies the value of the determination of CEA-serum level and urinary excretion of hydroxyprolin, spermidin and putrescin for monitoring the tumor behaviour particularly during cancer chemotherapy is demonstrated.
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The paper presents the comparison of the results of individualized postoperative chemotherapy and non-individualized treatment with Trenimon in ovarian cancer patients. Individual treated patients had a mean survival time of 9.7 months and the other group only 9.4 months, that means, there are no significant differences between the two treatment groups.
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To assess the clinical value of the organ culture drug prediction assay in the present study we summarize the results of two randomized trials in lung carcinoma (61 patients) and ovarian carcinoma (74 patients) comparing predicted and non-predicted or no surgical adjuvant chemotherapy. No real progress could be achieved by predicted cancer chemotherapy. The reasons of the negative results of our studies are discussed.
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A method for the detection of cellular tumor-versus-host relations is described, which consist in cultivating human tumor material together with autologous lymphocytes in one organ system and in determinating tumor and lymphocyte DNA synthesis separately before and after mixed organ culture. Advantages and disadvantages of this method are discussed. 58 human tumors were investigated (40 mammary, 13 gastric, 5 bronchial cancers). 37 tumors showed a sufficient in vitro growth. In about 50% of the mixed organ cultures, there was an increase in lymphocyte DNA synthesis compared to the controls. On the other hand, only in 9 cases a decrease in the tumor DNS synthesis could be observed under the influence of autologous lymphocytes. The investigations emphasize the individuality of the tumor-versus-host relations and lead to the consequence of a routine determination of the immune profile by a spectrum of several methods in tumor patients as a prognostic and therapeutic aid.
A method is reported for considering tumour-host relationships, which consists in cultivation of human tumours jointly with autologous lymphocytes in an organ culture system and determining separately tumour and lymphocyte DNA synthesis before and after mixed culture. Some experiments explore variables of the new system. For mixed organ cultures the best conditions are: 4-day incubation, lymphocyte DNA ratio to tumour cell DNA less than 9:1 (2-10(6) lymphocytes/ml) and autologous serum. So far 41 tumours (20 mammary, 17 gastric, and 4 bronchial carcinomas) have been examined. 22 tumours showed satisfactory in vitro maintenance. In 50% of the mixed organ cultures, lymphocyte DNA synthesis proved to be higher than in lymphocyte control cultures. Blast counts in the cell smears are in good accord with results obtained by biochemical determination of DNA synthesis. 7 of the tumours studied have shown a pronounced reduction of DNA synthesis in the presence of lymphocytes. The present results underline the individuality of tumour-host relationships and suggest the necessity of determinations of the immune reactivity in cancer patients. Advantages and disadvantages of the method are discussed.
The success of cytostatic chemotherapy depends on the numerous factors. Thus, apart from pharmacokinetic and cell kinetic factors, particular attention is being attached to the resistance at cell-biochemical level. In the past decade, a number of screening tests has been devised to avoid the use of ineffective cytostatic drugs in therapeutic schedules. The use of organ culture technique is described for cytostatic sensitivity tests in patients with operated bronchial carcinoma.
Histochemical and morphological methods are reported to test the sensitivity of organ culture of human and animal tumors to cytostatics. Topochemical investigations of lactate-dehydrogenase and NADH-diaphorase in organ culture of UV-induced mice tumors have shown that there is a considerably decreased enzyme activity, as compared with the controls, after application of a clinical as well as a tenfold clinical dose, especially after treatment with trenimon and 5-fluorurazil. On the other hand a decreased activity of these enzymes was found in organ cultures of tumors induced by methylcholanthren, following application of vinblastin and 5-fluorurazil. Three out of five of the investigated mammary carcinomas exhibited a markedly decreased enzyme activity when tested with cytostatics. Furthermore, a significant decrease of the enzyme activity was observed in two ovarian carcinomas and in two malignant melanomas of three tumors examined in each case. Following the administration of cytostatics, electronmicroscopical studies showed marked changes in the mitochondria in mammary carcinomas as well as in ovarian carcinomas, whereas no alterations were found in melanomas. The findings are discussed in the light of individual chemotherapy of cancer.