Cisplatin and 5-fluorouracil for advanced locoregional and metastatic squamous cell carcinoma of the skin

Article Abstract:

Squamous cell carcinoma of the skin, the second most common form of skin cancer, is most often cured by either surgical removal or by radiation therapy. These two treatments, which appear to be equally effective, cure roughly 90 percent of all patients with cutaneous squamous cell carcinoma. Metastatic spread of this form of skin cancer is not common, but occurs in 5 to 10 percent of affected patients. When tumors occur in antecedent scars, in immunosuppressed patients, or at the junction between mucous membranes and skin, metastatic spread is more likely. After this form of skin cancer has spread, systemic chemotherapy is required, and survival is less certain. While some previous studies on the effectiveness of doxorubicin, bleomycin, and methotrexate have been found to yield satisfactory responses in the patients, there is evidence that the combination of cisplatin and 5-fluorouracil might be more effective. This combination has already proved useful in treating squamous cell carcinoma of the head and neck, and squamous cell cancer of the esophagus. Furthermore, research has demonstrated that the effects of cisplatin and 5-fluorouracil are synergistic. When seven patients with advanced squamous cell skin cancer were treated with the combination of the two chemotherapeutic agents, complete responses were seen in three, and partial responses in three more. One of the patients achieving a complete response had metastatic disease in the lungs and bone; this may be the first reported case of a patient with metastatic squamous cell carcinoma in a visceral organ achieving a complete response. This patient, the only one in the group known to have survived, remains alive without evidence of disease after two years. One patient was lost to follow-up, and another patient with no evidence of disease died of a heart attack 13 months after treatment. The results of the treatment of these patients indicate that the combination of cisplatin and 5-fluorouracil is effective in treating advanced squamous cell carcinoma of the skin, and should be further evaluated for therapeutic use. (Consumer Summary produced by Reliance Medical Information, Inc.)

Squamous cell carcinoma, Skin cancer, Fluorouracil

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Etoposide: current and future status

Article Abstract:

Two recent symposia, one at the University of Maryland and the other in Geneva, Switzerland, were organized to discuss the current state of knowledge about the chemotherapeutic drug etoposide. The substance was first synthesized in the 1960s and first introduced into clinical trials in cancer treatment in the 1970s. Since that time, etoposide has played a key role in the treatment of small cell lung cancer and testicular cancer. In addition, etoposide is useful in the salvage therapy of some other types of cancer when the primary treatment has failed or the patient has relapsed. Hodgkin's disease, high-grade non-Hodgkin's lymphomas, and acute leukemia are among the diseases in which etoposide may be used for salvage therapy. However, it should not be assumed that the use of etoposide in the treatment of cancer is entirely worked out. Experiments with animals have shown that the dose of etoposide and the scheduling of the chemotherapy play important roles in the success of the treatment. Few data are available upon which to determine the optimal doses for human patients. In addition, there is much to be learned about the absorption and effectiveness of oral etoposide. Oral administration is considerably cheaper than intravenous, and there is some evidence that for prolonged administration it may also be more effective. Nevertheless, there seems to be considerable variability in the absorption of an oral dose of etoposide. If the oral route of administration is to be fully exploited, the optimal dosage and scheduling of treatment must be carefully determined. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Evaluation

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Complete remission of refractory small cell carcinoma of the pancreas with cisplatin and etoposide

Article Abstract:

Small cell cancer of the pancreas is a rare but fatal disease, with rapid progression. In the 15 reported cases, death occurred within two months after the onset of symptoms. The cancer is very metastatic, involving organs, tissues, and lymph nodes surrounding the pancreas. Experience is limited in the use of chemotherapy for treating the cancer. A case study is presented of a patient with widespread metastatic small cell carcinoma of the pancreas who was successfully treated with cisplatin and etoposide. The cancer had spread to the patient's liver and bone marrow. The patient was initially treated with the combined chemotherapy regimen of methotrexate, doxorubicin, cyclophosphamide and lomustine followed by streptozotocin and 5-fluorouracil without success. Twenty four months after the start of the second chemotherapy regimen, etoposide and cisplatin, the patient reached complete remission. The patient is presently still in remission 50 months following the initial cancer diagnosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Pancreatic cancer, Metastasis, Cancer metastasis

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