Fludarabine

Article Abstract:

The drug fludarabine was recently approved by the Food and Drug Administration for use in treating chronic lymphocytic leukemia (CLL), a cancer of the blood characterized by the overgrowth of lymphoid tissues, particularly the small lymphocytes, a type of immune cell. Fludarabine can be obtained through the National Cancer Institute. CLL is a common type of leukemia, which occurs most often in persons older than 50 years of age. Although fludarabine does not cure CLL, it can reduce signs and symptoms of this malignancy, which include decreases in red blood cells and platelets, cells involved in blood clotting; severe weight loss; tiredness; fever; enlargement of the spleen or lymph nodes; and an excess of lymph cells. Chlorambucil and prednisone are commonly used to treat patients with CLL, but cause complete remission in under 10 percent of treated patients. Fludarabine appears to act by interfering with the production of DNA, the genetic material of the cell. In clinical trials involving patients with CLL, fludarabine was shown to cause an improvement of symptoms in 32 to 57 percent of patients. One small study involving 33 CLL patients showed that fludarabine caused responses in 79 percent of patients, including 33 percent with complete responses. Adverse side effects of fludarabine include myelosuppression, or reduced bone marrow function; fever; infection; accumulation of fluid in tissues; and other disorders. High doses may cause a syndrome characterized by brain disease, blindness, and death. Fludarabine may also cause a lysis, or rupture, of tumors and impaired kidney function. The recommended dose of fludarabine and duration of treatment are described. The current evidence suggests that fludarabine is effective in treating CLL in patients who do not respond to standard treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Chronic lymphocytic leukemia

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Adjuvant chemotherapy of early breast cancer

Article Abstract:

The main factor determining the prognosis or expected outcome of breast cancer is the extent to which the lymph nodes in the axilla or armpit are involved. Studies show that 70 percent of breast cancer patients with no evidence of lymph node involvement (node-negative) at the time of diagnosis and treatment remain alive and free of disease after ten years. Thirty to 70 percent of patients showing involvement of lymph nodes (node-positive) in breast cancer will suffer a relapse depending on the number of nodes affected and various other factors. It is not clear whether node-negative or node-positive patients with breast cancer should receive adjuvant or additional therapy with cytotoxic drugs (chemotherapy), which destroy cancer cells and/or tamoxifen, which prevents the actions of the hormone estrogen. Although adjuvant therapy was shown to increase the survival among breast cancer patients without node involvement, the prognosis is excellent for patients with breast tumors of less than one centimeter in diameter without adjuvant therapy. Cytotoxic agents are recommended for women who have evidence of node involvement in breast cancer developing before menopause, the time of life when menstruation ceases. Among women who have breast cancer developing after menopause, treatment with cytotoxic agents and/or tamoxifen may increase survival. Tests to identify breast cancer patients who may or may not need anticancer therapy are currently being developed. These tests can evaluate the growth activity of the tumor based on measurement of deoxyribonucleic acid (DNA), a molecule that carries the genetic information of the cell, or cathepsin D, an enzyme dependent on estrogen. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Breast cancer, Tamoxifen

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Carboplatin

Article Abstract:

Carboplatin, a drug chemically related to the anticancer agent cisplatin, was recently approved for treating ovarian cancer. Carboplatin causes changes in the deoxyribonucleic acid (DNA) molecule, which carries the genetic information of the cell. The drug is eliminated mainly by the kidney with 50 to 70 percent of the dose detected in the urine within 24 hours. Carboplatin provided complete or partial improvement in patients with persistent or prolonged ovarian cancer; the greatest success occurred in patients not previously treated with cisplatin. Carboplatin caused the least improvement in patients who had not responded to cisplatin therapy. Among untreated patients with advanced ovarian cancer, carboplatin given alone or in combination with cyclophosphamide, another anticancer drug, effected a greater response rate and longer survival, and was better tolerated than cisplatin. Carboplatin is also effective in treating malignancies of the lung, head, neck, and testicles. Adverse effects of carboplatin include nausea, vomiting, toxicity of the kidney, nerves, and ear, bone marrow depression, and allergy. Carboplatin has also caused mutations, and toxic effects on the embryos of animals. The recommended dose of this anticancer agent is described. Carboplatin may cause remission in patients with recurrent or persistent ovarian cancer, but is less effective in patients resistant to cisplatin. In addition, carboplatin may be equally effective and less toxic than cisplatin for the initial treatment of patients with ovarian cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Ovarian cancer, Cisplatin, Carboplatin

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