Treatment of neuroendocrine carcinomas with combined etoposide and cisplatin: evidence of major therapeutic activity in the anaplastic variants of these neoplasms

Article Abstract:

The most common cancers are also the most thoroughly studied, if not the most successfully treated. On the other hand, there are a few rare cancers lacking a research program to determine the most effective treatment. Islet cell carcinoma, a cancer of the islet cells in the pancreas, and carcinoid tumors, a form of secreting cancer affecting different organs, are examples of such rare cancers. These cancers bear some similarity to small cell carcinoma of the lung, and thus it might be anticipated that treatments effective against small cell lung cancer might be effective against these rare cancers as well. However, there is a major difference between small cell lung cancer and these rare cancers. Small cell lung cancer is highly anaplastic, a term used by pathologists to indicate that the cancer cells have few of the characteristics of fully mature differentiated cells. Islet cell carcinoma and carcinoid , on the other hand, are usually composed of cells which have the appearance of highly differentiated tissue cells. However, a minority of islet cell carcinomas and carcinoid are anaplastic; a study has now found that these cancers may be preferentially sensitive to the effects of a combination of cisplatin and etoposide, the combination chemotherapy frequently used in the treatment of small cell lung cancer. A total of 45 patients were treated; 14 with islet cell carcinoma and 31 with carcinoid. Of the 27 patients with well differentiated cancers, only two responses to treatment were observed; both of these were only partial. In contrast, three patients of the 18 with anaplastic cancer responded completely and nine responded partially to treatment. The rarity of these tumors makes it difficult to ascertain the expected survival of such patients, but the 19 months median survival of the patients with the anaplastic tumors seems to be superior to that described published reports. (Consumer Summary produced by Reliance Medical Information, Inc.)

Carcinoid, Carcinoid tumor, Pancreatic tumors

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Treatment of high-risk gestational trophoblastic disease with chemotherapy combinations containing cisplatin and etoposide

Article Abstract:

Although the prognosis for gestational trophoblastic disease (GTD) has improved over the last decade, there remains a subpopulation of patients who die after developing drug resistance. To try to overcome this problem, a combination of cisplatin and etoposide was used in the treatment of 22 GTD patients. Of these, 12 patients were resistant to conventional therapy, 2 were experiencing recurrent disease, and 8 were receiving their initial treatment. Patient progress was monitored by measuring human chorionic gonadotrophin (hCG) in the blood; a patient was considered in complete remission if hCG levels remained normal for at least 12 months. All patients listed as being in complete remission were followed for a minimum of 24 months. Overall, 19 of the 22 patients (86 percent) were cured by the treatment protocol, which compares favorably to published recovery rates for other treatments. Gestational trophoblastic disease is rare enough to make full, randomized trials impractical, but the evidence suggests that the cisplatin and etoposide therapy is effective in managing patients who have developed drug resistance and as initial treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Cisplatin, vinblastin, and bleomycin combination in the treatment of resistant high-risk gestational trophoblastic tumors

Article Abstract:

Although gestational trophoblastic tumors (GTT) are among the most curable of all malignancies, the subpopulation of patients who do not respond to therapy with methotrexate and dactinomycin have a dismal prognosis. The response of 12 resistant high-risk GTT patients to treatment with cisplatin, vinblastine, and bleomycin was evaluated. Four patients were eliminated from the study due to scientific or medical reasons. The eight remaining patients had developed metastases. Following treatment with cisplatin, vinblastine and bleomycin six of the eight patients experienced complete remission. One of the six patients experienced a relapse four months after treatment. The remaining five GTT patients are listed as cured, with the durations of remission ranging from 30 to 96 months. The treatment protocol provided reasonable success and was well-tolerated by the patients. The combination of cisplatin, etoposide or vinblastine, and bleomycin or dactinomycin seem promising for the salvage of GTT patients when conventional treatment has failed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Chemotherapy, Combination, Combination chemotherapy, Bleomycin, Vinblastine

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