peplomycin and Skin-Neoplasms

Both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are very common in skin malignancy. Operative therapy is the first choice at the treatment for SCC and BCC in early stage. After excision for large skin tumor, occasionally we use skin flap or musculocutaneous flap or free flap. At the old patient of Stage III and IV SCC and BCC, sometimes reduction surgery is useful at the combination therapy. Radiation as adjuvant therapy is sometimes useful for not only SCC but also BCC. The clinical efficacy of CA (C' A') chemotherapy (CDDP, ADM or CBDCA, EPI-ADM), was evaluated on Stage III, IV SCC and BCC. The response rate was 63% in SCC and 75% in BCC.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Chemotherapy, Adjuvant; Cisplatin; Doxorubicin; Female; Humans; Lung Neoplasms; Lymph Node Excision; Male; Middle Aged; Palliative Care; Peplomycin; Prognosis; Radiotherapy, Adjuvant; Skin Neoplasms; Skin Transplantation; Surgical Flaps

Pulmonary toxicity was less frequent in pepleomycin treatment of squamous cell carcinoma than in bleomycin treatment. The tumor-regressing effect appeared at about day 10 of pepleomycin treatment, and at about day 21 of bleomycin treatment. The cumulative dose of pepleomycin to complete remission was smaller than that of bleomycin. Pepleomycin is effective against bleomycin-sensitive malignancies: squamous cell carcinoma and Hodgkin's disease. It is more effective than bleomycin against lymph node metastases. Pepleomycin may have a broader antitumor spectrum: prostatic carcinoma responded.

Topics: Antibiotics, Antineoplastic; Bleomycin; Drug Evaluation; Drug Resistance; Female; Head and Neck Neoplasms; Humans; Lymphoma; Male; Middle Aged; Neoplasm Metastasis; Peplomycin; Prostatic Neoplasms; Skin Neoplasms

Based on the fact that combination chemotherapy with cisplatin, ifosfamide, and bleomycin generated a 69% response rate in patients with recurrent cervical cancer; that 254-S (a cisplatin analogue) monotherapy generated a 46.3% response rate for cervical cancer, which was higher than those generated by cisplatin and carboplatin in historic comparison; and that peplomycin is a bleomycin analogue with improved pulmonary toxic effects, a combination regimen with 254-S, ifosfamide, and peplomycin was evaluated in an animal experiment and a clinical study in patients with advanced or recurrent cervical cancer with an expectation that the regimen might show a higher efficacy than 254-S monotherapy and the combination regimen including cisplatin.. In the clinical testing, 254-S was administered intravenously (IV) at 80-100 mg/m2, ifosfamide was administered IV at 1500 mg/patient for 5 days, and peplomycin was administered intramuscularly at 5 mg/patient for 6 days. This treatment was repeated every 4 weeks.. As a result, this regimen showed additive or synergistic antitumor effects in mice receiving B16 melanoma transplants. In the clinical study, 83.8% and 60.9% response rates were obtained in 37 previously untreated patients with Stage III or IV cervical cancer and 23 with recurrent cervical cancer, respectively. The dose-limiting factor was bone marrow toxic effects, which were tolerable. The other toxic effects were mild, and there were no deaths.. From these results, this combination regimen was thought worthy of evaluation in a Phase III comparative study in patients with advanced or recurrent cervical cancer.

Topics: Adult; Aged; Aged, 80 and over; Animals; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Drug Administration Schedule; Drug Screening Assays, Antitumor; Female; Humans; Ifosfamide; Infusions, Intravenous; Injections, Intramuscular; Melanoma, Experimental; Mice; Mice, Inbred Strains; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Neoplasm Transplantation; Organoplatinum Compounds; Peplomycin; Prognosis; Skin Neoplasms; Uterine Cervical Neoplasms

A study of combination chemotherapy with nitrosomethylurea, vincristine and peplomycin or bleomycetin given an 5-6-day cycles showed the cytotoxic regimens to be more effective than single-agent treatment with dacarbazine for disseminated melanoma of the skin with metastases to the subcutaneous fat, lymph nodes, lungs and other viscera. In a group of 129 such patients, complete (12%) and partial remission (38%) was observed with the former combination whereas with nitrosomethylurea, vincristine and bleomycetin, complete and partial response rates were 7.6 and 26.9%, respectively.

Topics: Adolescent; Adult; Aged; Antibiotics, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Female; Humans; Male; Melanoma; Methylnitrosourea; Middle Aged; Neoplasm Recurrence, Local; Peplomycin; Prospective Studies; Remission Induction; Skin Neoplasms; Vincristine

Peplomycin was given in a dose of 5 mg daily, divided into two equal parts for intramuscular administration each morning and evening. This schedule not only augments the antitumour effect but also reduces adverse reactions to the drug. Peplomycin-mitomycin C (P-M) therapy improves the response rates in T3 and T4 cases of skin cancer, and is also effective in some N1, N3 and M1 cases. Continuous intra-arterial infusion of peplomycin, though requiring somewhat complicated procedures, is very effective against squamous cell carcinoma of the head, neck and extremities. Multidisciplinary therapy incorporating peplomycin has given a considerably higher five-year survival rate than that found in historical controls.

Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Clinical Trials as Topic; Humans; Infusions, Intra-Arterial; Japan; Kinetics; Lung; Mitomycin; Mitomycins; Peplomycin; Skin Neoplasms; Tretinoin

Continuous intra-arterial (IA) administration of peplomycin (PEP) through a tumor-feeding artery is one of the most effective treatments for cutaneous squamous cell carcinoma (cSCC) in cosmetic areas.. In order to determine the effective and safe dose of PEP and the curative rate of IA-PEP, we retrospectively investigated a case series of 24 patients with cSCC on the lips who were treated with IA-PEP.. IA-PEP reduced the tumor mass in all 24 cases (100%). A complete response occurred in 17 patients (70.8%), and a partial response occurred in seven (29.2%). Moreover, 17 patients (70.8%) were cured, three patients developed cervical lymph node metastasis (12.5%), and four developed local recurrence (16.7%). Three out of the 24 patients developed interstitial pneumonia (12.5%).. Low-dose IA-PEP administered through a superficial temporal artery was a highly effective treatment that achieved a curative response for 70.8% of patients with cSCC on the lips.

Topics: Aged; Aged, 80 and over; Antibiotics, Antineoplastic; Carcinoma, Squamous Cell; Female; Humans; Infusions, Intra-Arterial; Lip Neoplasms; Male; Middle Aged; Neoplasm Staging; Peplomycin; Prognosis; Retrospective Studies; Skin Neoplasms; Temporal Arteries

Continuous intra-arterial administration of peplomycin (PEP) through a tumor-feeding artery using an intravascular indwelling catheter is one of the best treatments for cutaneous squamous cell carcinoma (SCC) on cosmetic areas. Although this reagent is useful for the treatment of SCC, its immunomodulatory effect on the tumor microenvironment is still unknown.. In this study, we investigated the immunomodulatory effects of PEP on the tumor-infiltrating regulatory T cells and tumor-associated macrophages as well as CD8(+)TIA-1(+) cytotoxic T cells in the lesional skin of 5 patients with SCC on the lips.. Our data suggest that, in addition to the direct antitumor effects, PEP decreased immunosuppressive cells and increased cytotoxic T lymphocytes at the tumor sites, which might maintain antitumor immune response against SCC.

Topics: Antibiotics, Antineoplastic; Carcinoma, Squamous Cell; Humans; Immunomodulation; Infusions, Intra-Arterial; Lip; Macrophages; Neovascularization, Pathologic; Peplomycin; Skin Neoplasms; T-Lymphocytes, Cytotoxic; T-Lymphocytes, Regulatory

A rare case of Stevens-Johnson syndrome (SJS) due to peplomycin in a 48-year-old man is described. The patient had squamous cell carcinoma on the scalp and underwent preoperative neoadjuvant chemotherapy with peplomycin. On the fifth day of the chemotherapy, he developed a fever and multiple dusky violaceous erythematous areas and pustules on his trunk, thighs, and palms. Erosive erythema and erosions also developed on his soles, scrotum, and oral mucosa. A biopsy specimen taken from the eruption on the thigh revealed marked liquefaction degeneration of the basal layer of the epidermis. Laboratory examinations demonstrated aggravation of liver function. Additionally, the patient developed conjunctivitis and corneal erosions. Although he had some subcorneal pustules, we diagnosed the case as an unusual form of SJS because of severe mucous membrane involvement. Oral prednisolone was administered, and the symptoms subsided. Then the patient underwent wide local excision. One month after surgery, we performed patch tests and a lymphocyte stimulation test with negative results. Then we re-administered peplomycin starting with 1/20 of a daily dose and gradually increasing the dose each day. After administration of the regular daily dose, the patient had a relapse of fever, eruptions, stomatitis, corneal erosions, and liver dysfunction. Therefore, a definite diagnosis of drug eruption due to peplomycin was made.

Topics: Biopsy, Needle; Carcinoma, Squamous Cell; Drug Eruptions; Follow-Up Studies; Hand Dermatoses; Humans; Immunohistochemistry; Male; Middle Aged; Mouth Mucosa; Peplomycin; Prednisolone; Risk Assessment; Skin Diseases, Vesiculobullous; Skin Neoplasms; Stevens-Johnson Syndrome; Treatment Outcome

Malignant melanoma is among the malignant tumors which still have the poorest prognosis. Thus, malignant melanoma of stage II and the more advanced stages. At present, chemotherapeutic combinations used as the first choice in Japan are two regimens of postoperative adjuvant therapy for stage II and III patients, that aim at preventing recurrence. One of the regimens is a DAV combination (Dacarbazine, ACNU, vincristine), and another is PAV combination (Pepleomycin, ACNU, vincristine). For stage IV patients, the major therapeutic procedure is a CDV combination (cisplatin, dacarbazine, vindesine). The efficacy of CDV treatment has been approximately 30 per cent in our studies. It has shown comparable effects for metastatic lesion in the lymph nodes, mucous membrane (nasal cavity) and brain, while lesions in other organs are largely unaffected in many instances. Studies of new drugs and combinations must be undertaken for the treatment of malignant melanoma.

Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Dacarbazine; Drug Administration Schedule; Female; Humans; Melanoma; Middle Aged; Nimustine; Peplomycin; Skin Neoplasms; Vincristine

In Japan the regimen with peplomycin has been mainly used for the treatment of squamous cell carcinoma (SCC). But recently, a regimen with cisplatin, particularly the combination of cisplatin and adriamycin (CA chemotherapy) has been used for the treatment of SCC, and a better prognosis has resulted Since CA chemotherapy is very effective for not only SCC, but also basal cell carcinoma (BCC), we think it is a prominent neoadjuvant therapy for SCC and BCC. We have used CA chemotherapy for multiple lung metastasis of BCC over the past six years, and three times PR was obtained, with survival so far.

Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Chemotherapy, Adjuvant; Cisplatin; Doxorubicin; Drug Administration Schedule; Female; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Peplomycin; Skin Neoplasms

In patients in whom cancer originating from a bed-sore has advanced to a stage where radical treatment is impossible, topical treatment with ointment, or systemic anti-cancer chemotherapy, is usually applied. We recently attempted treatment of extensive squamous cell carcinoma of the buttocks, for which radical treatment was impossible, by chemotherapy using a reservoir for intraarterial injection. This therapy involved intraarterial injection of bleomycin and 5-FU, together with topical treatment with 5-FU ointment. We describe the problems encountered with this therapy, e.g., measures against fever after intraarterial injection, management of the affected area, evacuation, possibility and limits of radiation therapy, and assessment of its efficacy.

Topics: Administration, Topical; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Buttocks; Carcinoma, Squamous Cell; Fluorouracil; Humans; Infusion Pumps; Infusions, Intra-Arterial; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Invasiveness; Ointments; Peplomycin; Skin Neoplasms

Topics: Animals; Bleomycin; Combined Modality Therapy; Hyperthermia, Induced; Male; Melanoma; Mice; Mice, Inbred BALB C; Mice, Nude; Neoplasm Transplantation; Peplomycin; Skin Neoplasms

Squamous cell carcinoma with hypercalcemia and leukocytosis arising from burn scars in a 45-year-old man is reported. Hypercalcemia and leukocytosis improved with pepleomycin treatment and worsened with recurrence of the tumor. Serum levels of parathyroid hormone, prostaglandin E and 25-OH-Vitamin D were within normal limits. Autopsy did not disclose any bone metastases or abnormalities of the parathyroid glands. It is suggested that hypercalcemia and leukocytosis were due to factors produced by the squamous cell carcinoma. This is the fifth reported case of cutaneous squamous cell carcinoma associated with hypercalcemia in the absence of bone metastasis or parathyroid gland abnormalities.

Topics: Bleomycin; Burns; Carcinoma, Squamous Cell; Cicatrix; Humans; Hypercalcemia; Leukocytosis; Male; Middle Aged; Peplomycin; Skin Neoplasms

Malignant melanoma is one of the most malignant froms of cancer, for which the prognosis is still very grave. However, it need not necessarily be regarded as such a fearful tumor if it is found at an early stage and treated thoroughly and adequately. An understanding of the early clinical changes in the size, color and shape of the tumor is required, and early discovery can save a patient's life. Histopathological examination should be done for diagnosis, and S-100 protein should be checked together with monoclonal antibody studies sometimes. The main principle of treatment in the early stage of malignant melanoma is to make an incision 2 to 5 cm away from the edge of the tumor. As a rule, exploratory excision and minor resection should not be performed. It may be said, accordingly, that multidisciplinary treatment should only be given for malignant melanoma of stage 1b and more advanced stages. At present, chemotherapeutic combinations used as the first choice in Japan are two regimens, one of which is DAV (DTIC, ACNU and vincristine), and the other, PAV (peplomycin, ACNU and vincristine). The effectiveness rate with DAV and PAV have been approximately 30% in various clinical studies. Favorable clinical responses obtained by radiotherapy have often been observed after fast neutron irradiation and hyperthermia therapy. Immunotherapy and interferon treatment are also often applied for malignant melanoma.

Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Combined Modality Therapy; Dacarbazine; Humans; Lymph Node Excision; Melanoma; Nimustine; Nitrosourea Compounds; Peplomycin; Prognosis; Skin; Skin Neoplasms; Vincristine

Bleomycins (BLM) are widely used as antineoplastic agents either alone or in combination regimens. Results of earlier studies in experimental animals were said to be inadequate to evaluate the carcinogenicity of BLM, which is a known mutagen. In a dose-response study, BLM and peplomycin (PEP) were investigated in Sprague-Dawley rats of both sexes. For the first 10 weeks weekly doses of 0.35, 0.70, 1.40, and 2.80 mg/kg BLM and of 0.32, 0.63, 1.25, 2.50, and 5.0 mg/kg PEP were applied subcutaneously (BLM: 30 male and 30 female rats/group; PEP: 25 male and 25 female rats/group). In the case of BLM, thereafter the doses were given once every fortnight either for 1 year (BLM: 1.40 and 2.80) or for life (lower doses). In the case of PEP, application of the high doses was stopped after the 13th time (5.0: 10 X 1/week and 3 X 1 every 2 weeks) and the 19th application (2.5 mg: 10 X 1/week and 9 X 1/every 2 weeks). After the 10th dosing, the remaining groups were treated once every fortnight for life. 60 male and 60 female rats served as solvent-treated (physiological saline) controls. The animals were observed for life. Repeated doses of BLM and PEP reduced body weight and life expectancy of the animals in a dose-related pattern. Tubular cell damages and cell proliferations were seen as a symptom of major toxicity in the kidneys. In this model BLM and PEP are carcinogenic: treatments resulted in significant dose-related incidences of animals with tumors at the site of application (fibrosarcomas) and with renal tumors (adenomas, adenocarcinomas, sarcomas).

Topics: Animals; Antibiotics, Antineoplastic; Bleomycin; Body Weight; Carcinogens; Dose-Response Relationship, Drug; Female; Injections, Subcutaneous; Kidney Neoplasms; Male; Peplomycin; Rats; Risk; Sex Factors; Skin Neoplasms; Time Factors

The application of a heat pad in the hyperthermia treatment of malignant skin tumors was examined. The temperature on the skin surface, and at a depth of 1 mm and 2 mm became 42C, 41C and 40C respectively, and was maintained for 4 hours. Two patients were treated with the heat pad alone, four were treated in combination with radiotherapy and one patient each with Pepleomycin injection and Bleomycin ointment. Irrespective of the above methods used, the heat pad was effective.

Topics: Adult; Aged; Bleomycin; Breast Neoplasms; Combined Modality Therapy; Female; Hot Temperature; Humans; Lung Neoplasms; Male; Middle Aged; Ointments; Peplomycin; Picibanil; Skin Neoplasms; Skin Temperature

A combination chemotherapy (PAV) consisting of peplomycin, ACNU and vincristine (VCR) was given to 30 patients with malignant melanoma and its therapeutic evaluation was performed. The objective response rate was 42.9% for the patients with stage IV metastatic lesions; three of 7 patients showed improvement. This regimen was particularly effective for both cutaneous and subcutaneous metastatic lesions. When PAV was applied as an adjuvant therapy to the operable cases with stage Ib and II, a five-year survival rate was 50% and the result was far better than that of operation alone. Our results in PAV regimen almost identical with those of DAV(DTIC, ACNU, and VCR) regimen as an adjuvant therapy. The result indicates that PAV regimen is useful for the treatment of malignant melanoma since toxic reactions were mild. Further studies are necessary to assess the efficacy of PAV regimen.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Drug Administration Schedule; Female; Humans; Melanoma; Nimustine; Nitrosourea Compounds; Peplomycin; Skin Neoplasms; Vincristine

1. The therapeutic effects of pepleomycin seem superior to those achieved with bleomycin against squamous cell carcinoma and malignant lymphoma. 2. In basal cell epithelioma, carcinoma in situ (e.g., actinic keratosis, Bowen's disease), adenocarcinoma (e.g., mammary and genital Paget's disease), and adult soft tissue sarcoma, pepleomycin as well as bleomycin was clinically ineffective. 3. Of the two cases of stage IV malignant melanoma, pepleomycin combined with MeCCNU and VCR exerted a moderate effect against multiple disseminated skin metastases in one, and a slight effect against a VI rib metastasis in the other. 4. The sorts of side effects of pepleomycin were almost the same as those of bleomycin. Lung toxicities were less frequent under pepleomycin treatment than those under bleomycin treatment.

Topics: Adolescent; Adult; Aged; Antineoplastic Agents; Bleomycin; Carcinoma, Squamous Cell; Drug Evaluation; Female; Humans; Japan; Lymphoma; Male; Melanoma; Middle Aged; Peplomycin; Skin Neoplasms

Topics: Animals; Antineoplastic Agents; Bleomycin; Carcinoma, Squamous Cell; Delayed-Action Preparations; Female; Mice; Neoplasms, Experimental; Oils; Peplomycin; Skin Neoplasms