picibanil and Carcinoma--Small-Cell

Symptomatic malignant pleural effusions should be treated systemic chemotherapy in chemo-sensitive tumors such as small cell lung cancer, breast cancer, lymphoma, or ovarian cancer. In other non-chemo-sensitive malignancies including non-small cell lung cancer, water-sealed tube drainage and pleurodesis is the standard treatment of choice in most of the cases. Drugs for instillation should be blomycin or OK-432 if commercially available. Instead of the former standard drug tetracycline, doxycycline has been frequently used. As we have no randomized trials, this drug awaits phase III trials. Talc slurry has been accepted and counted as one of the standard choices in the western countries, however, it usually needs general anesthesia and adverse effects are not negligible. As we have little experience on this modality, it should not be considered as a standard treatment. Other antitumor drugs instillation, thoraco-abdominal shunting, and pleuro-pneumonectomy should be considered experimental because of the lack of randomized trials. Symptomatic pericardial malignant effusion or cardiac tamponade is an oncologic emergency. We had better to treat the patient immediately by pericardiocentesis under the cardiac echographic guidance. It should be reserved to solve in randomized trials that the best method would be pericardiocentesis alone, percutaneous continuous drainage, pericardial fenestration, or pericardio-thoraco fenestration. Instillation of drug like doxycycline, OK-432, or bleomycin, lacks phase III comparison and it should be categorized as experimental.

Topics: Antineoplastic Agents; Bleomycin; Breast Neoplasms; Carcinoma, Small Cell; Drainage; Female; Humans; Lung Neoplasms; Pericardial Effusion; Picibanil; Pleural Effusion, Malignant; Randomized Controlled Trials as Topic

A study of postoperative adjuvant chemotherapy according to cell type, combined with immunotherapy using PSK and OK-432 was conducted in 178 lung cancer patients who had undergone resection. BRM (PSK or OK-432) was selected by randomization. Chemotherapy was mainly performed with VCR, MMC, and MTX except for small cell carcinoma. Of the total number of lung cancer cases, 113 were evaluable. Four-year survival rates were 36.7% for the OK-432 group, 55.9% for the PSK group and 34.7% for the control group, with significant differences among these three groups. Survival rates for stage III showed significant differences between immunochemotherapy groups, (OK-432 group, PSK group) and the chemotherapy group. Postoperative administration of immunomodulators is therefore considered to contribute to the improved survival of patients in lung cancer.

Topics: Adenocarcinoma; Adult; Aged; Biological Products; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Combined Modality Therapy; Female; Humans; Lung Neoplasms; Male; Middle Aged; Picibanil; Pneumonectomy; Postoperative Period; Prognosis; Proteoglycans; Random Allocation

The main reason for unfavourable surgical outcome of lung cancer is latent distant metastases over looked during surgery, which ultimately cause recurrence, or death of the patients even in cases undergoing curative surgery. This fact necessitates the indispensable use of systemic adjuvant therapy in patients under going surgery for lung cancer. There have been mary reports concerning the clinical efficacy of surgical adjuvant chemotherapy for non-small cell lung cancer using various kinds of drugs in various treatment modalities, but the results have been controversial. During the past eleven years, we have used postoperative chemotherapy in three ways over three different periods: in the earliest period, short-term combined chemotherapy (STCC) was used, in the middle period, intermittent long-term combined chemotherapy (ILTCC) was used in combination with immunotherapy for a randomized group, and in the latest period, when continuous long-term combined chemotherapy (CLTCC) with immunotherapy was employed. A comparison was then made between these three kinds of treatment groups. In Comparing of the results obtained for the earliest and middle periods, ILTCC showed a significantly improved beneficial effect over STCC in terms of further increased survival rate. Furthermore, by randomized study, it was clarified that the favourable effect of ILTCC was further improved by concomitant use of immunotherapy. CLTCC with immunotherapy carried out in the latest period seemed to be prevent early recurrences in patients with stage I or II who underwent curative surgery, even though a short-term observation period of for 20 months was employed. It is conceivable that the latest treatment modality used will exerted best the most favourable beneficial effect in comparison with the two early treatments. A review of the literature was presented along with a discussion of the clinical value of chemotherapy and immunochemotherapy as a surgical adjuvant.

Topics: Adenocarcinoma; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Biological Products; Carbazilquinone; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Clinical Trials as Topic; Combined Modality Therapy; Cyclophosphamide; Doxorubicin; Drug Administration Schedule; Female; Fluorouracil; Humans; Lung Neoplasms; Male; Middle Aged; Mitomycin; Mitomycins; Nimustine; Nitrosourea Compounds; Picibanil; Pneumonectomy; Postoperative Care; Random Allocation

We report a very rare case of small cell carcinoma of the stomach. A 69-year-old man, complaining of epigastric discomfort, was admitted to our hospital. Gastric endoscopy showed a Borrmann type 3 tumor at the lesser curvature of the cardia. Multiple liver metastases were observed in CT-scan, and total gastrectomy and cannulation to the hepatic artery were carried out. Macroscopically it was gastric cancer with P0H3N1T3M0, Stage IV b, histologically small cell carcinoma, intermed, INF gamma, ss, ly1, v3, n1(+), ow(-), aw(-). Immunochemotherapy was carried out, but liver metastases developed. The prognosis of this disease is very poor, resulting from rapidly developing metastases and invasion, in spite of treatments such as gastrectomy, chemotherapy and radiotherapy. More effective treatments are needed.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Small Cell; Chemotherapy, Adjuvant; Cisplatin; Gastrectomy; Humans; Infusions, Intra-Arterial; Liver Neoplasms; Male; Neoplasm Invasiveness; Picibanil; Stomach Neoplasms; Tegafur; Uracil

Chemotherapy and administration of OK-432 were performed concomitantly in 49 cases of inoperable primary lung cancer, and the Su-PS skin reaction was measured. In the group of patients under 60 years of age, the maximum diameter of the reaction after chemotherapy tended to be large, and evaluation of the results showed that the maximum diameter tended to be large in the group showing tumor contraction effects. In a comparison of the prognosis between the group which survived for less than 6 months and that which survived for 6 months or longer, there was no significant difference between them before administration of OK-432, but when the maximum reaction diameter after chemotherapy was compared, that in the group which survived for 6 months or longer was significantly stronger (p less than 0.05). The Su-PS skin reaction at the time of administration of OK-432 is therefore considered to be a useful immunological parameter for predicting the results of treatment and also for prognosis.

Topics: Adenocarcinoma; Adult; Aged; Biological Products; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Female; Humans; Lung Neoplasms; Male; Middle Aged; Picibanil; Polysaccharides, Bacterial; Prognosis; Skin; Skin Tests; Streptococcus pyogenes; Tuberculin Test

In order to study the role of immune skin reactions (DNCB, PPD, Su-PS reaction) in progressive lung cancer, various investigations were conducted, in particular during the administration of OK-432, and the following results were obtained. Before and after chemotherapy, only a slight decrease in the skin reactions was noted. Su-PS reaction was intensified by the administration of OK-432, but other skin reactions were not changed after 3 months, being only slightly intensified by long-term administration. At the time of remission achieved through radiochemotherapy during administration of OK-432, Su-PS reaction was intensified compared to the level before treatment, and a lowering tendency was noted at the time of recurrence. PPD reaction presented a similar tendency, but DNCB reaction did not show this trend. Concerning the relationship between skin reaction and survival period, the positive DNCB reaction group before treatment had a significantly extended survival period compared to that of the negative group. During administration of OK-432, Su-PS reaction was most useful at all timings, while PPD reaction occurred during the intermediate period. Upon observing the Su-PS reaction after 3 months of treatment, the prognosis was excellent in cases with erythema of 10 mm or more. However, no such tendency was noted for the PPD reaction. Thus, for understanding the pathologic state and prognosis of patients with progressive lung cancer, the Su-PS reaction was most useful during intra dermal administration of OK-432, the PPD reaction was moderately useful, but the DNCB reaction produced different results. Therefore, for the evaluation of prognosis, it was considered essential to select and combine the skin reactions according to the examination timing and treatment schedule.

Topics: Adenocarcinoma; Biological Products; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Dinitrochlorobenzene; Humans; Lung Neoplasms; Picibanil; Polysaccharides, Bacterial; Skin; Skin Tests; Streptococcus pyogenes; Tuberculin Test

In the course of administration of an immunopotentiator, streptococcal agent OK-432, a patient with lung cancer was found to have severe anemia and a strongly positive antiglobulin test. In the absence of the drug, eluates from the patient's erythrocytes reacted strongly by the indirect antiglobulin test with a panel of washed Group O erythrocyte samples. The eluated antibody was composed of monoclonal IgG1-lambda. Upon discontinuing the drug the patient's hemoglobin level increased slowly with concomitant normalization of the reticulocyte count. Although very rare, drug-induced immune hemolytic anemia should be included in the list of adverse effects of immunopotentiators. This is the first reported case of immune hemolytic anemia associated with OK-432.

Topics: Aged; Anemia, Hemolytic; Antibodies, Monoclonal; Biological Products; Blood Grouping and Crossmatching; Carcinoma, Small Cell; Haptoglobins; Hemoglobins; Humans; L-Lactate Dehydrogenase; Lung Neoplasms; Male; Picibanil; Serologic Tests

Active and adoptive immunotherapy as an adjunct to surgical treatment in non-small cell lung cancers was analysed, based on the results of our TF experiences and a literature review, and its significance was discussed.

Topics: Adjuvants, Immunologic; BCG Vaccine; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Combined Modality Therapy; Humans; Levamisole; Lung Neoplasms; Picibanil; Pneumonectomy; Postoperative Care

Topics: Adenocarcinoma; Antineoplastic Agents; Biological Products; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Combined Modality Therapy; Female; Humans; Lung Neoplasms; Male; Picibanil; Prognosis

We studied effects of OK-432 on the bone marrow and peripheral blood cells of lung cancer patients. The nuclear cell count of bone marrow increased in 5 to 7 patients upon intravenous treatment with OK-432 compared with 3 of 6 patients who were intramuscularly treated with OK-432. Serial neutrophil counts of bone marrow increased in all 7 patients treated intravenously compared with 3 of 6 patients treated intramuscularly. The mean nuclear cell count or the serial neutrophil count of bone marrow in intravenously treated patients was significantly higher than the pretreatment values (p less than 0.001). In the peripheral blood picture, the difference in white blood cells or neutrophils before and after intravenous treatment was also statistically significant (p less than 0.01). There was no change in the erythrocytic series count of bone marrow and the hemoglobin count. Our results support the superiority of intravenous OK-432 treatment over intramuscular treatment in the growth-accelerating effect on bone marrow cells, especially regarding the neutrophil series.

Topics: Adenocarcinoma; Adult; Aged; Biological Products; Bone Marrow; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Cell Division; Female; Humans; Infusions, Parenteral; Leukocyte Count; Lung Neoplasms; Male; Middle Aged; Neutrophils; Picibanil

Pleural effusions and sera of two patients with lung cancer were tested after intrapleural injection of OK-432 as an anticancer drug for IFN-alpha activity by biological assay and for IFN-alpha as an antigen by radioimmunoassay. The titers by radioimmunoassay were fairly consistent with those by biological assay, but were usually higher. In Case 1, IFN-alpha was observed fairly early after administration of OK-432 and only in pleural effusions. In Case 2, induction of IFN-alpha at low level was observed late after the first administration of OK-432 both in the pleural effusion and serum and was detected only by radioimmunoassay.

Topics: Adenocarcinoma; Aged; Biological Products; Carcinoma, Small Cell; Drug Therapy, Combination; Female; Humans; Injections; Interferon Type I; Lung Neoplasms; Male; Middle Aged; Mitomycin; Mitomycins; Picibanil; Pleura; Pleural Effusion