Altretamine for ovarian cancer
Article Abstract:
Altretamine is the generic name of drug previously known by its chemical name, hexamethylmelamine. It has been approved for use as an oral agent, used alone, for palliative treatment (that is, relieving without curing) of persistent or recurrent ovarian cancer. The drug structurally resembles other alkylating agents, which interfere with cell growth. However, it has an unknown mechanism of action and is effective against tumors that are resistant to alkylating agents. Standard initial drug therapy for ovarian cancer has included cisplatin plus cyclophosphamide, with or without doxorubicin. Altretamine has produced response rates of 15 to 25 percent in patients with recurrent or persistent cancer who were previously treated with cisplatin combinations. However, altretamine has often been used in the initial drug protocols, frequently in combination with cyclophosphamide, doxorubicin, and cisplatin (H-CAP therapy). H-CAP produced a complete response in 19 of 55 patients in one study. There are few studies of the effectiveness of initial protocols with and without altretamine, but one study found that, in women without residual tumor following surgery, survival was better in those treated with H-CAP than in those treated with cisplatin plus cyclophosphamide. Side effects involve the gastrointestinal (vomiting) and neurological systems; peripheral neuropathy (dysfunction of nerves outside the brain) and possibly confusion, dizziness, depression, and seizures may occur. The report indicates that altretamine may be useful as a palliative agent, but its usefulness in initial combination therapy of ovarian cancer is not yet proven. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1991
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Levamisole with fluorouracil for colon cancer
Article Abstract:
Levamisole, an antiparasitic drug, is now available for investigational use with the anticancer agent fluorouracil for treating colon cancer that has metastasized or spread to the lymph nodes. Levamisole activates portions of the nerve called ganglions, inhibits the enzyme fumarate reductase in parasites, inhibits the enzyme alkaline phosphatase in mammals, and activates the body's natural defense mechanisms, or the immune system. The mechanism of its antitumor effect is not known. Levamisole is absorbed by the gastrointestinal tract, broken down in the liver, and eliminated completely within two days in the urine and feces. In a study of 401 patients with advanced colon cancer, adjuvant or supplemental therapy with levamisole with and without fluorouracil decreased the recurrence of the cancer and increased the survival rate. The dosage of levamisole required for treating ovarian cancer is discussed. Adverse effects of this drug include nausea, vomiting, flu-like symptoms, rash, dizziness, confusion, metallic taste, blurred vision, convulsions, and fatal agranulocytosis, a decrease in white blood cell count. Other toxic effects are oral and gastrointestinal ulcers, dermatitis or inflammation of the skin, hair loss, and bone marrow depression. Adjuvant treatment with levamisole and fluorouracil may decrease the recurrence of disease and prolong the survival of patients with metastatic colon cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1989
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