melphalan and Rectal-Neoplasms

Topics: Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Carmustine; Colonic Neoplasms; Drug Evaluation; Fluorouracil; Humans; Lomustine; Melphalan; Methotrexate; Rectal Neoplasms; Semustine; Vincristine

Topics: Adult; Aged; Clinical Trials as Topic; Colonic Neoplasms; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Fluorouracil; Humans; Infusions, Parenteral; Male; Melphalan; Middle Aged; Neoplasm Metastasis; Rectal Neoplasms

Topics: Adult; Aged; Clinical Trials as Topic; Colonic Neoplasms; Drug Therapy, Combination; Fluorouracil; Humans; Melphalan; Middle Aged; Nitrosourea Compounds; Rectal Neoplasms; Semustine

Topics: Adenocarcinoma; Clinical Trials as Topic; Colonic Neoplasms; Drug Evaluation; Drug Therapy, Combination; Female; Fluorouracil; Humans; Male; Melphalan; Middle Aged; Rectal Neoplasms

Topics: Adult; Aged; Biliary Tract Diseases; Clinical Trials as Topic; Colonic Neoplasms; Drug Evaluation; Female; Fluorouracil; Gastrointestinal Neoplasms; Humans; Male; Melphalan; Middle Aged; Pancreatic Neoplasms; Rectal Neoplasms; Stomach Neoplasms

Stage-3 extramedullary plasmacytoma of the large intestine was diagnosed in an 8-year-old Labrador Retriever. Three primary tumors were located in the colon and rectum, with metastasis to local lymph nodes and the spleen. The disease was associated with a monoclonal serum protein spike identified as IgG. Treatment consisted of surgical excision followed by chemotherapy, using melphalan and prednisone. The dog remained free from clinical signs of disease and adverse effects of the chemotherapy at 9 months. Findings in this dog indicated that extramedullary plasmacytoma may be an aggressive disease, associated with spread to distant sites and monoclonal gammopathy.

Topics: Animals; Biopsy, Needle; Blood Protein Electrophoresis; Chemotherapy, Adjuvant; Colonic Neoplasms; Dog Diseases; Dogs; gamma-Globulins; Lymphatic Metastasis; Male; Melphalan; Plasmacytoma; Prednisone; Rectal Neoplasms; Splenic Neoplasms

To augment the antitumor effect of high-dose melphalan and determine pharmacokinetics we conducted a phase I trial of escalating doses of high-dose IV melphalan with the chemosensitizer misonidazole for patients with advanced colorectal carcinoma. Fourteen patients with modified Dukes D adenocarcinoma of the colorectum were treated with a single course of melphalan (40-60 mg/m2 i.v. bolus q.d. X 3 days) and misonidazole (1-3 g/m2 p.o. q.d. X 3 days) followed by autologous bone marrow transplantation. Toxicity consisted of severe myelosuppression, moderate nausea and vomiting, and mild mucositis and diarrhea. One patient developed unexplained renal tubular acidosis, and a diffuse encephalopathy occurred in another patient. Three patients died within the first 30 days after the start of treatment, two due to tumor progression and one due to sepsis and disseminated intravascular coagulation-induced intracerebral hemorrhage. Six of 14 patients achieved a partial response, and the median response duration was 4 months (range 3-10 months). Analysis of misonidazole serum concentrations showed similar pharmacokinetics to those previously reported, suggesting no significant drug interaction with intravenous melphalan. Mean peak serum concentrations ranged from 81.8 micrograms/ml to 115.2 micrograms/ml at the second and third misonidazole dose levels, which approximate those known to provide effective chemosensitization with melphalan in animal models. In this phase I study, we showed that maximally tolerated doses of intravenous melphalan can safely be combined with oral misonidazole. In view of the large volumes of oral misonidazole required at the highest dose level, subsequent studies to determine the maximally tolerated dose of misonidazole should employ the intravenous form.

Topics: Adenocarcinoma; Adult; Antineoplastic Combined Chemotherapy Protocols; Bone Marrow Transplantation; Colonic Neoplasms; Drug Administration Schedule; Drug Evaluation; Female; Humans; Male; Melphalan; Middle Aged; Misonidazole; Neoplasm Metastasis; Rectal Neoplasms; Remission Induction

Topics: Agar; Animals; Biopsy; Breast Neoplasms; Cell Survival; Colonic Neoplasms; Colony-Forming Units Assay; Culture Techniques; Female; Humans; Male; Melanoma; Melphalan; Mice; Neoplasms; Ovarian Neoplasms; Rectal Neoplasms; Tumor Stem Cell Assay

New concepts and treatments currently available for adjuvant studies are illustrated by a review of ongoing studies sponsored by the National Cancer Institute. More thorough information is needed on immunotherapeutic agents to allow more rationale in the use of these agents. Solid bases to properly select drugs or drug combinations for adjuvant purposes are being established. However, dose-schedule and duration of treatment are still to be defined. Strategies directed at prolonging the benefit of surgical adjuvant chemotherapy remain to be planned. Progress continuously achieved with immunotherapy and chemotherapy should rapidly broaden the spectrum of tumour types to be included in adjuvant studies.

Topics: Antineoplastic Agents; Breast Neoplasms; Cisplatin; Colonic Neoplasms; Cyclophosphamide; Dianhydrogalactitol; Doxorubicin; Drug Therapy, Combination; Female; Fluorouracil; Humans; Lung Neoplasms; Male; Melphalan; Methotrexate; Neoplasms; Osteosarcoma; Rectal Neoplasms

In a prospective phase II study, 25 patients with advanced (Duke's D) colorectal adenocarcinoma received 0.25 mg/kg of melphalan orally daily for 4 days every 28 days. There were 17 men and eight women. All patients had measurable areas of known malignant disease which served as objective indicators of the response to chemotherapy. All patients were evaluated for at least two cycles of therapy. Each patient had had previous treatment with 5-fluorouracil and, in addition, 24 of 25 patients had had treatment with methyl-CCNU; all patients had disease progression with both regimens. Toxicity consisted of mild gastrointestinal symptoms and transient leukopenia (wbc count less than 4000/mm3) in nine of 25 (36%) patients and thrombocytopenia (platelet count less than 100,000/mm3) in six of 25 (24%). One of 25 (4%) patients had an objective response for 12 weeks, 15 of 25 (60%) had disease progression, and nine of 25 (36%) remained stable for 2 months. We conclude that melphalan is ineffective for patients with metastatic colorectal carcinoma who have previously failed to respond to both 5-fluorouracil and methyl-CCNU.

Topics: Adenocarcinoma; Adult; Aged; Colonic Neoplasms; Drug Evaluation; Female; Fluorouracil; Humans; Male; Melphalan; Middle Aged; Neoplasm Metastasis; Prospective Studies; Rectal Neoplasms; Semustine

Topics: Antineoplastic Agents; Breast Neoplasms; Busulfan; Carcinogens; Cyclophosphamide; Humans; Leukemia, Myeloid; Lung Neoplasms; Melphalan; Methotrexate; Neoplasms; Pancreatic Neoplasms; Rectal Neoplasms; Triaziquone; Urinary Bladder Neoplasms

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Adenocarcinoma, Scirrhous; Antibiotics, Antineoplastic; Antineoplastic Agents; Breast Neoplasms; Carcinoma, Squamous Cell; Culture Techniques; Flavonoids; Fluorouracil; HeLa Cells; Humans; Lung Neoplasms; Melphalan; Mercaptopurine; Methods; Mitomycins; Neoplasms; Rectal Neoplasms; Stomach Neoplasms

Topics: Abdomen; Antineoplastic Agents; Chemotherapy, Cancer, Regional Perfusion; Colonic Neoplasms; Cyclophosphamide; Female; Geriatrics; Hodgkin Disease; Humans; Hypothermia; Hypothermia, Induced; Leiomyosarcoma; Mechlorethamine; Melanoma; Melphalan; Neoplasms; Ovarian Neoplasms; Pancreatic Neoplasms; Pelvis; Rectal Neoplasms; Retroperitoneal Neoplasms; Uterine Cervical Neoplasms; Vaginal Neoplasms