A phase II study of the combination of etoposide and cisplatin in the therapy of advanced gastric cancer

Article Abstract:

Although the incidence of stomach cancer has been decreasing in the United States, it remains a leading cause of cancer death. Worldwide, gastric cancer may well be the most common deadly cancer. A wide variety of chemotherapeutic agents have been reported to be effective against stomach cancer, yet often the same regimen provides widely varying results when used by different researchers. Cisplatin, one of the newer agents to be shown effective in some studies of stomach cancer, has shown synergy with etoposide (VP-16) in both animal models and several human cancers. It seems reasonable, then, to try a combination of cisplatin and etoposide in the treatment of stomach cancer. For this study, 48 patients with advanced gastric cancer were treated with a combination of cisplatin and etoposide. The majority of patients experienced severe but reversible toxic effects. The overall rate of regression of the tumors, including both complete and partial regression, was only 28 percent. Of the 48 patients, 44 died at a median of 4 months after the beginning of the study. Four patients remained alive a median of 12 months. The results are disappointing, and the combination of cisplatin and etoposide seems to offer no benefits over other treatment protocols. However, it is worth noting that regressions were only moderately reduced among patients who had received previous chemotherapy, indicating that there is little cross-resistance with other treatments. This information may be useful in the design of future treatment protocols. Furthermore, when measurements were made of human chorionic gonadotrophin (hCG), a hormone normally made by the embryo in pregnant women, 21 percent of the patients with stomach cancer had elevated levels. These patients experienced higher rates of regression than those who were hCG negative. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cisplatin, Etoposide

---

A clinical trial of biochemical modulation of 5-fluorouracil with N-phosphonoacetyl-L-aspartate and thymidine in advanced gastric and anaplastic colorectal cancer

Article Abstract:

The antitumor drug 5-fluorouracil exerts its cytotoxic effect by being incorporated into newly synthesized RNA within a cell. The drug is similar enough to uracil to be incorporated into RNA, but not close enough for the resulting RNA to do its normal job. Since cancer cells are often more metabolically active than their normal neighbors, they may suffer disproportionate damage from the cytotoxic drug. Currently, there is much interest in the use of additional compounds that can modulate the impact that 5-fluorouracil has on a cell. For example, the addition of thymidine tends to interfere with the metabolic destruction of 5-fluorouracil, leaving more for incorporation into the RNA. The compound PALA (N-phosphonoacetyl-L-aspartate) inhibits the enzyme aspartate transcarbamylase; the resulting depletion of pyrimidines (uracil, thymidine, and cytosine) within the cell results in the greater uptake of 5-fluorouracil into the cells. Unfortunately, any attempt to translate these biochemical events into therapeutic advantage has not been promising. Thirty-six patients with advanced gastric cancer and 21 with advanced anaplastic colorectal cancer were treated with 5-fluorouracil, thymidine, and PALA. The potency of 5-fluorouracil was clearly enhanced by the treatment; dose-limiting toxicity, in the form of a reduction in white blood cells, occurred at only one tenth the normal maximum tolerated dose of 5-fluorouracil. Infection following this leukopenia was responsible for four deaths. Responses were observed in 25 percent of the stomach cancer patients and 33 percent of the colorectal cancer patients. However, these responses were short-lived. The median survival of the stomach cancer patients was 6 months; that of the colorectal cancer patients was 3.5 months. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Physiological aspects, Colorectal cancer, Dosage and administration, Fluorouracil, Chemotherapy, Combination, Combination chemotherapy, Thymidine

---

A phase III trial on the therapy of advanced pancreatic carcinoma: evaluations of the Mallinson regimen and combined 5-fluorouracil, doxorubicin, and cisplatin

Article Abstract:

Pancreatic cancer accounts for 25,000 deaths in the United States each year, and is the fifth largest cause of cancer death. Despite continued research, the success of chemotherapy in treating pancreatic adenocarcinoma is, at best, limited. Only 15 percent of patients may be expected to achieve some regression at treatment, and these regressions are likely to last no more than four months. Ninety-eight percent of patients with pancreatic cancer will die of their disease. An experimental evaluation of three chemotherapeutic regimens was conducted on 187 patients, who were randomly assigned to receive 5-fluorouracil alone, a combination of 5-fluorouracil, doxorubicin, and cisplatin, or the Mallinson regimen, which consists of 5-fluorouracil, cyclophosphamide, methotrexate, vincristine, and mitomycin C. The results were disappointing. Of the patients whose disease could be objectively measured, 7 percent responded to 5-fluorouracil, 15 percent to the combined regimen, and 21 percent to the Mallinson regimen. The responses lasted an average of two and a half months. The median survival for the 5-fluorouracil and the Mallinson regimen was 4.5 months; the survival for the remaining group was somewhat shorter at 3.5 months. Chemotherapy of pancreatic cancer remains an exercise in futility, and a therapeutic procedure that can be recommended for these patients has not yet been identified. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Pancreatic cancer

Similar abstracts:

• Abstracts: Evaluation of high-dose etoposide combined with cisplatin for treating relapsed small cell lung cancer
• Abstracts: Frequency of adverse reactions to influenza vaccine in the elderly: a randomized, placebo-controlled trial. Lessons from the influenza vaccine recall of 1996-97
• Abstracts: Breast cancer adjuvant therapy. Adjuvant therapy for Stage II breast cancer
• Abstracts: Reevaluation of procarbazine for the treatment of recurrent malignant central nervous system tumors. Poorly differentiated gliomas of the cerebellum: a study of 18 patients
• Abstracts: Anaplastic carcinoma of the thyroid: a clinopathologic study of 121 cases. Islet cell carcinoma of the pancreas: a study of 98 patients

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.