aclarubicin and Carcinoma--Transitional-Cell

The present investigation was conducted to examine the effect of neoadjuvant PVB and CAP regimens for locally invasive bladder cancer and consisted of two studies: (1) a retrospective nonrandomized study of neoadjuvant PVB therapy, and (2) a well-controlled randomized study of neoadjuvant CAP therapy. A total of 25 patients with primary locally invasive bladder cancer were entered into the PVB study between January 1981 and December 1985. Since 1986, 31 patients have been randomized into the CAP study. In the PVB-treated group, a 71.4% complete response (CR) plus partial response (PR) rate and a 71.4% downstaging were noted. On the other hand, in the CAP-treated group, a 50.0% CR plus PR rate and a 88.9% downstaging were noted. The 2- and 5-year survival rates of neoadjuvant PVB were 78.6 and 60.6%, respectively. In contrast, the 2-year survival rate of the neoadjuvant CAP-treated group was 100% at a mean follow-up of 15.8 months. No statistical significance was achieved in the survival rates. These results indicated that neoadjuvant PVB and CAP would be useful in the management of invasive bladder cancer.

Topics: Aclarubicin; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Transitional Cell; Cisplatin; Combined Modality Therapy; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Neoplasm Invasiveness; Peplomycin; Randomized Controlled Trials as Topic; Retrospective Studies; Survival Analysis; Urinary Bladder Neoplasms; Vinblastine

Ten patients with advanced bladder cancer were treated with intra-arterial infusion therapy. The patients consisted of nine males and one female between 55 and 82 years old (median: 70 years). In all patients, cisplatinum (CDDP) (2 mg/kg), aclacinomycin (ACR) (0.5 mg/kg) and Angiotensin II (25 mg) were infused via the internal iliac artery for a period of about 30 minutes. Seven patients also received X-ray therapy with a linac. The efficacy of this therapy was assessed by computed tomographic scanning, sonography and cystoscopy. As a result of this assessment, 2 patients were rated complete response "(CR)", 6 partial response (PR) (showing 50% or more reduction in the lesion) and 2 no change "(NC)". To compare the efficacy of this therapy for two histopathologically defined groups of patients (patients with grades 2 and 3 cancer), one patient was rated "CR", four "PR" and two "NC" in the grade 3 group (total 7 patients), while one was rated "CR" and two "PR", in the grade 2 group (total 3 patients). In effective cases, pollakiuria and miction pain disappeared shortly following intra-arterial infusion therapy. As for side effects of the therapy, mild nausea or vomiting was observed in all patients, while leukopenia was noted in one patient.

Topics: Aclarubicin; Aged; Aged, 80 and over; Angiotensin II; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Transitional Cell; Cisplatin; Combined Modality Therapy; Drug Administration Schedule; Female; Humans; Infusions, Intra-Arterial; Male; Middle Aged; Naphthacenes; Remission Induction; Urinary Bladder Neoplasms

Thirteen patients with recurrent superficial bladder tumors were treated by combined intravesical instillation of Aclacinomycin-A (ACM) and cytosine arabinoside (CA). Prophylactic effects of this combined instillation therapy were studied in 7 patients. A solution of 200 micrograms/ml of ACM and 600 micrograms/ml of CA was instilled into the bladder. The instillation aimed for treatment was carried out once a week until ten treatments had been given. Complete response was attained in 2 patients and partial response in 3 patients, but tumor size increased by more than 50% in 6 of the 13 patients. No change was observed in the remaining 2 patients. Recurrence of the tumors was observed in 3 of the 7 patients who were treated by this prophylactic combined instillation therapy. Local side effects such as bladder irritability were found in 2 of the 20 patients. No systemic side effects were noted in any patients. Although the side effects were reduced, we were not satisfied with the results of this therapy.

Topics: Aclarubicin; Administration, Intravesical; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Transitional Cell; Cytarabine; Drug Evaluation; Female; Humans; Male; Middle Aged; Naphthacenes; Neoplasm Recurrence, Local; Remission Induction; Urinary Bladder Neoplasms

In vitro and in vivo effects of mitoxantrone, aclacinomycin-A and doxorubicin were examined in a transplantable murine transitional bladder carcinoma, FCB. The in vitro parameters used included monolayer growth kinetics, tumor stem-cell colony formation and autoradiographic analysis of thymidine labeling. Monolayer growth kinetics revealed that both mitoxantrone and aclacinomycin-A resulted in reductions in FCB cell growth, which were significantly higher (41% and 65%, respectively) than those seen with doxorubicin treatment (22%). Similarly, by the stem-cell assay, an increased reduction in colony formation was seen in aclacinomycin-A (98%) and mitoxantrone (91%) treated cultures when compared with doxorubicin (51%) treated cultures. Autoradiographic data revealed that 24-h exposure with both aclacinomycin-A and mitoxantrone significantly inhibited thymidine incorporation (98% and 80% respectively), which was an increase over doxorubicin (19%). In vivo studies revealed that aclacinomycin-A treatment increased the mean life span of C57BL mice by 60.6% when compared with a 33.6% increase in doxorubicin-treated animals and a 19.7% increase in mitoxantrone-treated animals. Both the in vitro and in vivo data suggest that aclacinomycin-A is a superior drug when used against this specific murine bladder tumor cell and that further testing of this agent for its efficacy in other urologic tumors is justified.

Topics: Aclarubicin; Animals; Carcinoma, Transitional Cell; Cell Division; Cell Line; Dose-Response Relationship, Drug; Doxorubicin; In Vitro Techniques; Mice; Mice, Inbred C57BL; Mitoxantrone; Naphthacenes; Time Factors; Tumor Stem Cell Assay; Urinary Bladder Neoplasms

Topics: Aclarubicin; Antineoplastic Agents; Carcinoma, Renal Cell; Carcinoma, Transitional Cell; Colony-Forming Units Assay; Doxorubicin; Drug Evaluation, Preclinical; Humans; Kidney Neoplasms; Kidney Pelvis; Naphthacenes; Tumor Stem Cell Assay; Urinary Bladder Neoplasms; Vinblastine