Successful treatment of metastatic thymic carcinoma with cisplatin, vinblastine, bleomycin, and etoposide chemotherapy

Article Abstract:

Tumors of the thymus are rare, and may exist in three forms: benign thymoma, malignant thymoma, and thymic carcinoma. The latter two are distinguished by the fact that the malignant thymoma shows signs of invasion or spread, although the cells themselves are histologically normal, while the cells of the thymic carcinoma are histologically atypical. The preferred treatment for thymic carcinoma is surgery, as chemotherapy is generally ineffective. Therefore, the prognosis for patients with thymic carcinoma that has already spread is poor. However, a case is now reported in which a patient with metastatic thymic carcinoma was chemotherapeutically treated and remains a long-term survivor without evidence of disease after five years. The patient, a 21-year-old male, had a chest mass, and tumor cells within a lymph node were revealed by biopsy. Although a germ cell tumor had been suspected initially, histological appearance of the lymph node was consistent with metastatic thymic carcinoma. The patient was treated with a combination regimen including cisplatin, vinblastine, bleomycin, and etoposide. After four cycles of chemotherapy, the area of the chest mass was surgically removed; examination revealed only scar tissue with no live tumor cells, indicating a complete response to the chemotherapy. Two additional cycles of chemotherapy were given after surgery as consolidation therapy. Although the optimum therapy for metastatic thymic carcinoma remains unknown, the success with this patient indicates that a combination therapy including cisplatin and bleomycin and either vincristine or etoposide may be a good choice for first-line treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Thymoma, Endocrine gland tumors

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A phase II of mitoguazone and vinblastine in advanced transitional cell carcinoma of the urinary tract

Article Abstract:

Cisplatin is the current drug of choice in the treatment of cancer of transitional cells in the urinary tract. To evaluate some other possible chemotherapeutic treatments, patients with metastatic or recurrent cancer of the urinary tract transitional cells were treated with vinblastine, which inhibits the mitotic process, or with mitoguazone, which inhibits polyamine synthesis. A total of 52 patients were treated; 24 with mitoguazone and 28 with vinblastine. The results indicate that, at least as single agents, these drugs are inferior to cisplatin. Vinblastine and mitoguazone induced responses in 20 and 11 percent of the patients, respectively. Median survival was 14.3 weeks for patients treated with mitoguazone and 17.9 weeks for those receiving vinblastine. The toxicity due to both drugs was severe. Almost half of the patients receiving vinblastine experienced hematologic toxicity described as severe or worse. Although neither vinblastine nor mitoguazone seems to be useful as a single agent, the fact that they operate by different mechanisms than some other drugs suggests that they may find use in chemotherapeutic combinations. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Cisplatin, Urinary tract cancer, Urologic cancer, Vinblastine

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Neoadjuvant methotrexate, vinblastine, doxorubicin, and cisplatin for locally advanced transitional cell carcinoma of the bladder

Article Abstract:

When transitional cell carcinoma (TCC) of the bladder invades the local muscle, the five-year survival rate drops to roughly 50 percent, even when the disease has remained confined to the bladder. This survival rate has not changed appreciably in 20 years, despite refinements in chemotherapy and other aspects of cancer care. A retrospective review was conducted of nine male patients with advanced transitional cell carcinoma of the bladder. These patients received neoadjuvant therapy with methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) prior to surgical removal of the bladder, prostate gland, and pelvic lymph nodes. The surgically removed tissue was evaluated by a pathologist to see how it had responded to the chemotherapy. Two patients showed a complete response and an additional four showed a partial response. A clinical trial to compare the survival rates of patients treated with surgery alone versus those with M-VAC and surgery is currently underway and should be reported in the near future. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Cancer, Adjuvant chemotherapy, Bladder cancer

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