peplomycin and Thyroid-Neoplasms

The Japanese Society of Thyroid Surgery undertook a pilot study of treatment for anaplastic thyroid carcinoma in a cooperative setting. The treatment consisted of cisplatin 40 mg/m2 drip intravenous infusion (div), day 1, adriamycin 60 mg/m2 iv, day 1, etoposide 100 mg/m2/day div, days 1-3, peplomycin 5 mg/body/day sc, days 1-5 and granulocyte colony-stimulating factor (G-CSF) 2 micrograms/kg/day sc, days 6-14. This was scheduled to be repeated every 3 weeks. Local radiation therapy was added for patients in whom it was indicated. A total of 17 patients (mean age, 66 yr) were enrolled. Ten patients had advanced disease with measurable lesions and 2 patients experienced partial remission lasting 2 and 3 months, respectively. Six of 7 patients were treated with the same modality of treatment as an adjuvant. Three died of progressive disease after 3-7 months and three others have survived for 3-11 months. The toxicities of the chemotherapy were mainly bone marrow suppression, despite G-CSF support. Transient liver dysfunction was also noticed. These results indicate that this combined a treatment can be given to patients with acceptable toxicity. The degree of leukopenia was greater than expected, partly due to the advanced age of the patients and the low dose of G-CSF. In addition, 8 available thyroid specimens were examined for the mdr 1 gene and P-glycoprotein, but all were negative. Further study of anaplastic thyroid carcinoma by this cooperative group will be carried out.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma; Carcinoma, Squamous Cell; Cisplatin; Combined Modality Therapy; Doxorubicin; Etoposide; Female; Granulocyte Colony-Stimulating Factor; Hematologic Diseases; Humans; Male; Middle Aged; Peplomycin; Pilot Projects; Survival Rate; Thyroid Neoplasms; Thyroidectomy

The resistance of malignant tumors to chemotherapy with anticancer drugs has been considered to be due partly to overexpression of the multidrug resistance gene (mdr1) and its gene product, P-glycoprotein (P-GP), which acts as a drug efflux pump for several chemotherapeutic agents. In order to elucidate the mechanism of anticancer drug resistance in anaplastic thyroid carcinoma with very poor prognosis, we examined the expression of mdr1 mRNA and P-GP, and analyzed their relationships to chemotherapy response. Twenty surgical samples from 16 patients with anaplastic thyroid carcinoma were used. The mdr1 mRNA expression was examined by reverse transcription and polymerase chain reaction, and P-GP expression was evaluated by an immunohistochemical method using JSB-1 monoclonal antibody. Of the 20 clinical samples, expression of mdr1 mRNA and P-GP was observed in three and four samples, respectively. Three of the patients from whom the samples were obtained had been given anticancer drugs before biopsy. Of 12 patients who received chemotherapy for clinically evaluable diseases, 2 responded well, but 10 showed no response. All except one patient died of cancer progression. There was no relationship between the response to chemotherapy and the expression of mdr1 and P-GP. The expression of mdr1 mRNA and/or P-GP was observed in 5 of 16 patients with anaplastic thyroid carcinoma. However, the appearance of anticancer drug resistance in anaplastic thyroid carcinoma may not be explained solely by the expression of mdr1 and P-GP.

Topics: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; ATP Binding Cassette Transporter, Subfamily B, Member 1; Carcinoma; Carmustine; Cyclophosphamide; Doxorubicin; Drug Resistance, Multiple; Etoposide; Female; Gene Expression; Humans; Immunoenzyme Techniques; Male; Middle Aged; Peplomycin; Polymerase Chain Reaction; RNA, Messenger; Thyroid Neoplasms

Rats were treated for 1 week each with 0.05% N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN), 0.2% N-bis(2-hydroxypropyl)-nitrosamine (DHPN) and 0.2% N-ethyl-N-hydroxyethylnitrosamine (EHEN) in the drinking water, and then administered diet containing 5% sodium L-ascorbate (Na-AsA), 1% butylated hydroxytoluene (BHT) or 0.05% phenobarbital (PB), or weekly intraperitoneal injections of 2 mg of pepleomycin per kg body weight until week 36. Histopathological examination revealed that all exerted significant modulation effects on tumor development in the various target organs. Na-AsA was found to inhibit liver but promote renal pelvis and bladder carcinogenesis. BHT similarly decreased liver and enhanced bladder lesion development. PB, in contrast promoted hepatocarcinogenesis. However both PB and BHT were associated with increased incidences of adenomas and adenocarcinomas of the thyroid. Thus the wide-spectrum initiation model allowed confirmation of site-specific modification potential and in addition demonstrated potentiation of kidney and bladder carcinogenesis promotion by pepleomycin.

Topics: Animals; Ascorbic Acid; Bleomycin; Body Weight; Butylated Hydroxytoluene; Cocarcinogenesis; Kidney Neoplasms; Liver Neoplasms; Lung Neoplasms; Male; Neoplasms, Experimental; Peplomycin; Phenobarbital; Rats; Rats, Inbred F344; Thyroid Neoplasms; Urinary Bladder Neoplasms

The blood lymphocyte population was monitored in 6 patients with advanced malignant tumors who were treated with large doses of a new cytotoxic drug termed pepleomycin. It was observed that the size of the cell population, its cellular composition, mitogen stimulations and natural killer activity did not change in any consistent ways during or after treatment. It is concluded that pepleomycin does not directly affect the lymphocytic population.

Topics: Adenocarcinoma; Adult; Aged; Antineoplastic Agents; Bleomycin; Female; Fibrosarcoma; Humans; Kidney Neoplasms; Killer Cells, Natural; Leiomyosarcoma; Leukocyte Count; Lymphocytes; Male; Middle Aged; Neoplasms; Peplomycin; Testicular Neoplasms; Thyroid Neoplasms