A prospective evaluation of a triple-drug regimen containing cisplatin, vinblastine, and dacarbazine (CVD) for metastatic melanoma

Article Abstract:

Anumber of chemotherapeutic regimens have been used for the treatment of metastatic melanoma, cancer of the melanocytes or pigment-containing cells of the skin. The different therapies have included single and multiple drug regimens. Dimethyl-trizeno-imadazole-caroxamide (DTIC) is the single drug that is most widely accepted, and the reported response rate is approximately 20 percent. The use of a triple drug regimen, consisting of CVD (cisplatin, vinblastine, and DTIC) was evaluated in the treatment of 50 patients with advanced melanoma. The overall response rate was 40 percent and the median duration of response was 9 months. A complete response was seen in 2 patients and 18 had a partial response. The survival time for responders was 12 months and the overall survival time for patients treated with this drug regimen was 9 months. The treatment was toxic, resulting in nausea, vomiting, diarrhea, hair loss, decrease in the number of red and white blood cells and platelets; neurological symptoms included numbness and tingling. However, the toxicity was no worse than when DTIC was used alone. It was concluded that treatment with the combination of cisplatin, vinblastine, and DTIC is more effective than treatment with only DTIC. Both the response rate and duration of response was approximately two times greater with the combination therapy. The 9- to 12-month survival time of the patients treated with CVD exceeded the 4- to 6-month survival time of patients treated with the one drug. A comparative trial is need to further test the effectiveness of CVD compared with DTIC. (Consumer Summary produced by Reliance Medical Information, Inc.)

Antineoplastic agents, Cisplatin, Vinblastine, Dacarbazine

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Small cell osteosarcoma: A clinicopathologic study of 27 cases

Article Abstract:

Osteosarcoma, cancer of the bone, has different clinical and pathological characteristics. One rare type of osteosarcoma is small cell osteosarcoma (SMO). The clinical and pathologic features of 27 patients with SMO were reviewed. The median age of the patients was 14 years old; the ages ranged from 6 to 14 years. When tumor tissues were examined, three cell types were found: Ewing's-like, lymphoma-like, and spindle cell. All the samples contained bone formation and a few had cartilage formation. Glycogen, a storage form of sugar, was found in the cytoplasm of the cells in 10 of the cases. The patients with SMO received various treatments. Ten of the cases were treated with infusion by the anti-neoplastic drug cisplatin through arteries near the tumor; four had amputations; two underwent partial removal of the mandible; one had local radiotherapy and chemotherapy, and 10 had surgical resection or amputation followed by chemotherapy. Forty-four percent of the patients survived past 90 months; 52 percent died from metastases in the lung, spine, or brain, 1 to 23 months after the initial diagnosis. One patient had a relapse in the lung but was still alive after 90 months. The effectiveness of the various treatments are difficult to compare because patients were treated in so many different ways. Local treatment with chemotherapy appears to be effective in treating primary tumors, but not metastases. Additional study is needed to evaluate the effects of chemotherapy in patients with SMO. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Histology, Pathological, Pathological histology, Bone cancer, Osteosarcoma

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A phase II trial of taxol in metastatic melanoma

Article Abstract:

Metastatic melanoma often has a rapid course and the overall patient response to treatment is poor. A new compound was evaluated for the treatment of metastatic melanoma in 25 patients who had not previously received any chemotherapy. The compound, called taxol, is derived from the bark and needles of the western yew plant (Taxus brevifolia). Three patients had a partial response to treatment with taxol. In many studies, a partial response is defined as a measurable reduction in tumor of more than 50 percent. In this study, an additional four patients experienced responses that did not qualify as partial responses; these responses were labelled minor responses. Taxol was not shown to be an effective treatment for metastatic melanoma, especially since the patient population studied had not previously failed chemotherapy and did not include patients with metastases to the brain. However, it was observed that the duration of the responses was somewhat longer than usually observed for melanoma. In this study taxol did not reach 20 percent response rate generally regarded as the cutoff point for an agent to be considered an 'active' anti-cancer drug. Taxol has limited, but demonstrable effectiveness against melanoma when used as a single agent. (Consumer Summary produced by Reliance Medical Information, Inc.)

Taxol

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