Continuous infusion gallium nitrate for patients with advanced refractory urothelial tract tumors

Article Abstract:

Tumors that develop in the lining of the urinary tract are often responsive to chemotherapy. Unfortunately, the responses of these urothelial tumors are generally not long-lasting, and long-term patient survival is infrequent. Observing that cisplatin, a compound including platinum in its chemical structure, is effective against urothelial tumors, researchers have begun to evaluate other metal compounds in the search for more effective chemotherapeutic drugs. One metal that has shown some promise is gallium. In the present study, researchers evaluated the use of gallium nitrate in the treatment of 40 patients with urothelial cancer. All patients had advanced cancer which had already proved unresponsive to a standard treatment of methotrexate, vinblastine, doxorubicin, and cisplatin. Gallium nitrate was administered by continuous infusion; in 17 patients, the dose was gradually escalated to determine the toxicity of the drug. The compound was found to be relatively well tolerated, but no clinical effectiveness was observed until a dose of 350 milligrams of gallium nitrate per square meter of body area per day was given. Twenty-three patients were started at this level with increments to 400 milligrams if no toxic effects were observed. Suppression of the bone marrow, a common complication of chemotherapy, was minimal among these patients, but 3 of the 11 patients who received 400 milligram (per square meter) daily doses of gallium nitrate developed abnormalities of the optic nerve. These abnormalities, which prevented the use of a higher dose, were fortunately reversible and resolved after chemotherapeutic treatment. Three partial responses and one complete response were observed in these patients. In a group of patients with advanced cancer who have already failed chemotherapy, this is a promising result and suggests that further evaluation of gallium nitrate in the treatment of urothelial tract cancer is appropriate. The four responses in the present group of patients lasted from two to eight months before disease progression continued. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Gallium nitrate, Urinary tract cancer, Urologic cancer

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Two-drug therapy in patients with metastatic germ cell tumors

Article Abstract:

For many forms of cancer, the major thrust of chemotherapeutic research is to improve long-term survival. However, success rate achieved with chemotherapy in the treatment of patients with metastatic germ cell tumors is already good. The focus of chemotherapeutic research in this instance, therefore, is to minimize undesirable side effects while maintaining therapeutic effectiveness. One way of reducing toxic effects is to eliminate drugs with more serious side effects, such as bleomycin, from the therapeutic regimen. Preliminary results have shown that a five-drug regimen including bleomycin may be replaced by a two-drug treatment consisting of cisplatin and etoposide without sacrificing therapeutic effectiveness. This drug combination has now been evaluated on 82 patients with metastatic germ cell tumors with special attention being paid to the possibility of late relapses, that is, relapses more than two years after chemotherapy. Seventy-two patients achieved a complete response to chemotherapy alone; four additional patients achieved a complete response after chemotherapy and surgery. Nine patients suffered relapses, all within 18 months of treatment. Three of these relapsed patients were salvages and remain disease free at 59 to 63 months. A total of 71 patients, therefore, remain disease-free over periods ranging from 33 to 92 months. These results indicate that a two-drug regimen consisting of etoposide and cisplatin is effective with only modest toxicity in the treatment of advanced germ cell tumors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Complications and side effects, Germ cell tumors, Germinoma, Cancer, Cisplatin, Bleomycin, Etoposide

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