pirarubicin and Adenocarcinoma

Topics: Adenocarcinoma; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Carcinoma, Squamous Cell; Cisplatin; Combined Modality Therapy; Cyclophosphamide; Doxorubicin; Finger Phalanges; Follow-Up Studies; Humans; Ifosfamide; Lung Neoplasms; Male; Middle Aged; Radiotherapy, Conformal

Polyamines are recognized as cell growth factors. We attempted to determine whether blood polyamines are useful biochemical makers for monitoring the efficacy of the chemotherapy on bladder tumors.. The blood concentrations of three polyamines, diamine, spermidine and spermine, were determined in 31 patients with invasive urinary bladder carcinoma, following chemotherapy with cisplatin, methotrexate and pirarubicin. Clinical response was evaluated by CT after 3 weeks. In 26 patients who underwent subsequent surgical therapy, the effectiveness of the chemotherapy were histopathologically evaluated by a pathologist according to the response criteria for bladder cancer treatment.. Mean regression rate in the size of the tumor after the chemotherapy was 40.8%. Of 31 patients, clinical CR was observed in 2, PR in 11, and NC in 18. Of 26 patients who were histopathologically evaluated, grade 3 was observed in 5, grade 2 in 4, grade 1b in 4, grade 1a in 12, and grade 0 in 1. One week after chemotherapy, the levels of spermine and total polyamine in the patients with CR and PR were significantly lower than those in the patients with NC. Similarly one week after chemotherapy, the levels of spermine and total polyamine in the patients with grade 3 and grade 2 were significantly lower than those in the patients with grade 1b, grade 1a and grade 0.. The study suggested that the levels of blood polyamines could be used as biochemical markers for monitoring the efficacy of the chemotherapy on bladder tumors.

Topics: Adenocarcinoma; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Carcinoma, Squamous Cell; Carcinoma, Transitional Cell; Cisplatin; Doxorubicin; Female; Humans; Male; Methotrexate; Middle Aged; Monitoring, Physiologic; Polyamines; Treatment Outcome; Urinary Bladder Neoplasms

A total of 20 patients with hormone-refractory prostate carcinoma entered a pilot study of combination chemotherapy based on the EAP (etoposide, Adriamycin and cisplatin) regimen, in which Adriamycin was replaced by pirarubicin, a less cardiotoxic derivative of Adriamycin. The response was assessed by criteria modified from those of the National Prostatic Cancer Project: prostate-specific antigen was employed instead of acid phosphatase. Of 18 evaluable patients, 6 achieved a partial response, 5 had stable disease, and in 7 the disease had progressed during therapy; thus, the overall response rate was 33.3% [95% confidence interval (CI) 11.5-55.1%]. Significant pain alleviation and performance status improvement were obtained in 5 of 12 patients (41.7%; CI 13.8-69.6%) and 3 of 13 patients (23.1%; CI 0.2-46.0%), respectively. Although myelosuppression was moderate to severe, no chemotherapy-related deaths or bacteriologically documented sepsis occurred; nor was there any clinical cardiotoxicity. All the responding patients received maintenance chemotherapy with etoposide thereafter. At present, the median duration of response is 33 weeks (range: 23-91 weeks) and the median survival period for all patients is 42 weeks (range: 27(+)-136 weeks), with 12 deaths. In spite of the small number of patients treated, these results suggest that this chemotherapy regimen is active in advanced hormone-refractory prostate carcinoma.

Topics: Adenocarcinoma; Aged; Aged, 80 and over; Antibiotics, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Cisplatin; Doxorubicin; Drug Resistance; Estrogens; Etoposide; Gonadotropin-Releasing Hormone; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Orchiectomy; Prostatic Neoplasms; Treatment Outcome

From 1986 to 1990, a multicentric phase II study was conducted with pirarubicin, a new semi-synthetic anthracyclin[4'-O-tetrahydropyranyl-adriamycin (THP)]. 87 patients with advanced gynaecological cancers were treated: epidermoid cervical carcinoma (n = 31), adenocarcinoma of the endometrium (n = 28) and ovarian adenocarcinoma (n = 28). THP was administered by short intravenous infusion, for 3 consecutive days, every 3 weeks. The initial dose of THP was 25 mg/m2 day (25% of patients) which was then reduced to 20 mg/m2 day. The average number of courses was 3.7 (range 1-10). The cumulative THP dose was 180 mg/m2 (range 56-594) in cervix and endometrial tumours and 121 mg/m2 (range 58-425) in ovarian tumours. Myelosuppression was the major observed toxicity with grade 3-4 leukopenia and thrombocytopenia in 62 and 19% of the patients, respectively. Severe general complications occurred in 6% of the patients with three fatalities due to infections. Gastro-intestinal side-effects were frequent and usually mild (7% of grade 3 vomiting). 48% of the patients showed alopecia, which was complete in 9 cases (10%). 3 patients experienced cardiac events. No significant antitumoral activity was observed in patients who had failed to respond to previous chemotherapy. Promising antitumoral activity was noticed in untreated cervico-uterine carcinomas with 19% partial responses and 12% complete responses (CR). THP activity was lower in endometrial carcinomas (9.5% CR). Results were found to be negligible in ovarian cancer patients, most of them being refractory to previous chemotherapy containing an anthracyclin compound. On the basis of these results, the definite role of THP in gynaecological cancers deserves to be studied in more favourable programmes (e.g. in combined protocols as first-line chemotherapy).

Topics: Adenocarcinoma; Adult; Aged; Alopecia; Antineoplastic Agents; Doxorubicin; Endometrial Neoplasms; Female; Humans; Leukopenia; Middle Aged; Ovarian Neoplasms; Thrombocytopenia; Uterine Cervical Neoplasms; Vomiting

Thirty elderly (over 70 years) women with measurable advanced breast cancer entered into this Phase II study. An initial dose of 30 mg/m2 of pirarubicin (THP) every 3 weeks was given intravenously. THP was escalated by levels of 10 mg/m2 according to the blood cell count done at day 14 and day 21 until a maximum dose per cycle of 70 mg/m2 was reached. The mean total cumulative dose of THP received was 204 mg/m2 (range 30-710 mg/m2). The mean number of cycles given was 5.5 (range 1-24). Of 28 evaluable patients, 1 achieved a complete response (CR), 6 had a partial response (PR) (CR + PR = 25%; 95% confidence interval 9-41%), 13 showed no change, and 5 had a progressive disease. The median time to progression was 3 months (range 0.5-18+ months). Of 28 patients evaluable for toxicity, the hematologic toxicity at day 15 was neutropenia grade 3 and 4 in 61% of the patients and thrombopenia grade 3 and 4, 0% of cycles. No cumulative hematologic toxicity was detected. Nonhematologic toxicities consisted of nausea and vomiting in 50% of patients (WHO grade 3 = 5%) and alopecia in 64% (WHO grade 2-3 = 36%). No stomatitis occurred. No cardiac toxicity was observed. The results of this study show that THP is an active drug in elderly patients with advanced breast cancer. Because of its safety, THP deserves further investigation in this application.

Topics: Adenocarcinoma; Aged; Aged, 80 and over; Antibiotics, Antineoplastic; Breast Neoplasms; Doxorubicin; Drug Evaluation; Female; Humans; Remission Induction; Survival Analysis

A multi-institutional collaborative phase II study of (2"R)-4-O-tetrahydropyranyladriamycin (THP) was performed by intravenous administration to patients with advanced or recurrent gastric cancer. The administration schedules were (1) 40-60 mg/body every 3 or 4 weeks and (2) 20-40 mg/body once a week. Of 58 registered patients, 49 cases were eligible and 37 cases were evaluable for response. The therapeutic results were 1 CR, 4 PR, 14 NC and 18 PD. The response rate of the evaluable cases was 13.5%. The side effects were mainly bone marrow suppression and digestive symptoms. In particular, the frequency of leukopenia was a high 75.5%, while there was a decrease in hemoglobin in 38.8% and anorexia in 30.6%. The frequency and severity of alopecia, which is a known problem with anthracyclines, were slight, and no abnormal electrocardiograms were observed.

Topics: Adenocarcinoma; Adult; Aged; Anorexia; Bone Marrow; Doxorubicin; Drug Administration Schedule; Female; Humans; Infusions, Intravenous; Leukopenia; Male; Middle Aged; Stomach Neoplasms

4'-O-Tetrahydropyranyl adriamycin (THP adriamycin) is a new anthracycline active as a single drug in advanced breast cancer. We have undertaken a phase II study as first-line treatment for metastatic disease with THP adriamycin day 1 = 40 mg/m2 i.v. bolus and 5-fluorouracil day 1 to day 5 = 750 mg/m2 as a continuous i.v. infusion. The dose of THP adriamycin was further escalated up to the maximal tolerated dose defined as grade 3 granulopenia for each patient. Thirty-nine patients were included, 37 being so far evaluable for toxicity and for efficacy. The mean number of cycles given was 5 (range: 2-12). The overall response rate (CR + PR) was 54% (95% CI: 37.9-70.1) and the CR rate 8%. Sites of response were as follows: lung 6/9, liver 11/18, breast 4/8, nodes 7/14, skin 3/8, bone 2/8. Neutropenia with grade 3 + 4 nadir values was observed in 70.2% of the patients according to the objective of the study. No severe thrombopenia or anemia occurred. Stomatitis grade 3 was seen in 27% and grade 4 in 3% of the patients. Alopecia grade 2 was seen in 18% and grade 3 in 9%. No other toxicity was observed. We conclude that this association is effective in metastatic breast cancer, giving few alopecia. A high response rate in liver metastases warrants further evaluation.

Topics: Adenocarcinoma; Adult; Aged; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Doxorubicin; Drug Administration Schedule; Drug Evaluation; Female; Fluorouracil; Hematologic Diseases; Humans; Middle Aged

Pirarubicin (THP) was conjugated onto the pendant carboxyl groups of poly(ethylene glycol)-block-poly(l-lactide-co-2-methyl-2-carboxyl-propylene carbonate) [PEG-b-P(LA-co-MCC)] through hydrazone, ester, and amide bonds, respectively, and the conjugates were assembled into micelles with diameters between 30 and 60 nm. The in vitro THP release of the three conjugate micelles was conducted in pH 7.4 and 5.0 buffer solutions, and conjugate micelles with hydrazone linkage had the fastest THP release rate. Their in vitro cytotoxicity was tested using mouse mammary adenocarcinoma EMT6 cells and in vivo anti-tumor activity in Balb/c mice models bearing EMT6 tumors were compared with free THP and with each other. The results showed that the polymer-THP conjugates displayed higher cell-uptakes and better anti-tumor activities than free THP at 4h, and among the three micelles, those with hydrazone linkage had the highest anti-tumor activity in vivo, while those with amide linkage were the lowest.

Topics: Adenocarcinoma; Amides; Animals; Antibiotics, Antineoplastic; Biological Transport; Breast Neoplasms; Cell Line, Tumor; Cell Survival; Chemistry, Pharmaceutical; Dose-Response Relationship, Drug; Doxorubicin; Esters; Female; Hydrazones; Hydrogen-Ion Concentration; Kinetics; Mice; Mice, Inbred BALB C; Micelles; Particle Size; Polyesters; Polyethylene Glycols; Polymers; Propane; Solubility; Technology, Pharmaceutical

Although anthracyclines are considered as being among the most potent chemotherapeutic agents for endometrial carcinoma, the majority of institutions in Japan prefer a combination of paclitaxel and carboplatin (TC) for treating this disease. We retrospectively evaluated the efficacy and feasibility of combined paclitaxel, pirarubicin, and carboplatin (TPC) therapy for endometrial carcinoma.. Thirty-nine patients with high/intermediate postoperative recurrence risks or with advanced disease received combination chemotherapy consisting of paclitaxel (150 mg/m(2)), pirarubicin (35 mg/m(2)), and carboplatin [area under the concentration time curve (AUC = 4)] from 2001 to 2006 at Okayama University Hospital. Treatment cycles were repeated every 3 weeks, and three to nine cycles were administered according to patient risk.. The 1-year overall survival (OS) and progression-free survival (PFS) rates were 94.9% and 84.6%, respectively, and the 3-year OS and PFS rate was 81.3%. Hematologic toxicities >grade 3 were: anemia 30.8%; leukopenia 84.6%; thrombocytopenia 20.5%. Neutropenia was common, and administration of granulocyte colony-stimulating factor (G-CSF) was necessary in 87.9% of treatment courses. Although grade 3 or 4 neutropenia was unavoidable, we could administer TPC therapy safely and without delay with G-CSF support. Gastrointestinal and neurological toxicity were less severe and less frequent compared with TC, and no cardiac toxicity was observed.. The 3-year PFS and OS rates even in high-risk patients were satisfactory, and we confirmed the feasibility of using this regimen for treating endometrial carcinoma.

Topics: Adenocarcinoma; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Carboplatin; Chemotherapy, Adjuvant; Disease-Free Survival; Doxorubicin; Endometrial Neoplasms; Feasibility Studies; Female; Humans; Hysterectomy; Japan; Kaplan-Meier Estimate; Lymph Node Excision; Middle Aged; Neoplasm Staging; Paclitaxel; Pilot Projects; Retrospective Studies; Time Factors; Treatment Outcome

To evaluate the effect of pirarubicin (THP) in combination with hyperthermia on gastric cancer tissues in vitro and explore the underlying mechanisms.. In vitro three-dimensional culture models were established with tissue biopsies from 36 patients with pathologically confirmed gastric cancer. The tumor cell viability was measured by MTS-PMS assay, and HE staining was used to study the histomorphological changes of the tissues following chemotherapy and hyperthermia.. Synergistic tumor cell-killing effects of cisplatin, THP, and mitomycin with hyperthermia was observed in the tumor tissues (P=0.000), and THP exhibited stronger cytotoxic effects than the other drugs. Histomorphological study suggested strong killing effects of THP on the tumor tissues, which displayed disrupted tissue structure, cellular degradation and necrosis, karyopyknosis and karyolysis, with cytoplasm loss. The anti-tumor effects of THP were associated with clinical staging and pathological grading of the tumors (P=0.000), but not with the patients' gender, age, tumor size and preoperative CEA levels (P>0.05).. Pirarubicin shows good synergistic effects with hyperthermia, and the cytotoxicity of pirarubicin against gastric cancer tissue is enhanced considerably by mild hyperthermia. THP can be a potential therapeutic drug for intraperitoneal chemohyperthermia.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Antineoplastic Agents; Cell Survival; Cisplatin; Doxorubicin; Drug Synergism; Female; Hot Temperature; Humans; Hyperthermia, Induced; Male; Middle Aged; Mitomycin; Stomach Neoplasms; Tissue Culture Techniques; Tumor Cells, Cultured

Topics: Adenocarcinoma; Adult; Antineoplastic Combined Chemotherapy Protocols; Carboplatin; Carcinoma, Squamous Cell; Chemotherapy, Adjuvant; Combined Modality Therapy; Doxorubicin; Female; Humans; Hysterectomy; Lymph Node Excision; Middle Aged; Uterine Cervical Neoplasms

We report a case of malignant pericardial effusion due to breast cancer that was successfully controlled by intrapericardial chemotherapy using pirarubicin. A 53-year-old woman underwent breast conserving therapy for left breast cancer in 1996. She was given CAF therapy and UFT as adjuvant therapy. Three years and 10 months after operation, she had malignant pericardial and pleural effusion. Pericardiocentesis and pleurocentesis were performed immediately. Pericardial effusion relapsed after some time and she was treated with intrapericardial chemotherapy using pirarubicin. After this treatment she has not suffered from pericardial effusion for 1 year and 4 months to date. This case suggests that intrapericardial chemotherapy is effective for malignant pericardial effusion.

Topics: Adenocarcinoma; Antibiotics, Antineoplastic; Breast Neoplasms; Doxorubicin; Female; Humans; Middle Aged; Pericardial Effusion; Pericardium; Pleural Effusion, Malignant

In the treatment of 2 patients with recurrent gastric cancer who showed bone metastasis and lymph node recurrence, we administered 30 mg/body of pirarubicin (THP) on the first day of treatment, and 30 mg/body of cis-platinum (CDDP) and 500 mg/m2 of 5-fluorouracil (5-FU) for 3 days (FP therapy). Marked effects were achieved. Gastric cancer of Borrmann IV type was diagnosed in Case 1, and total gastrectomy was performed. The histological type was poorly differentiated adenocarcinoma, and the histological classification was II. A bone metastasis was found three years after operation. The patient was CR after three courses of treatment, and has survived for 2 years. In Case 2, advanced gastric cancer was treated with neoadjuvant chemotherapy and distal gastrectomy. The histological type was moderately differentiated adenocarcinoma, and the histological classification was IIIa. Obstructive jaundice due to lymph node recurrence developed 6 years after operation. Two courses of treatment were provided after PTCD, and PR was observed. The patient has survived for 3 months. Both patients exhibited mild side effects such as anemia and leukocytopenia, but no serious complications were observed. Although various dosage regimens of FP therapy have been investigated, there has been a certain limit to the response rate achieved by this therapy, and new protocols have been explored. We achieved marked effects in 2 patients by adding THP to FP therapy. These cases are reported here together with some discussion of cases reported in the literature.

Topics: Adenocarcinoma; Aged; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Combined Modality Therapy; Doxorubicin; Drug Administration Schedule; Female; Fluorouracil; Gastrectomy; Humans; Middle Aged; Stomach Neoplasms

Prognosis of patients with stage IVB endometrial adenocarcinoma is quite poor. Combination therapy of radiation with surgery or chemotherapy is a common therapy for advanced endometrial cancers. However, radiation therapy is effective only for localized cancer, and the chemotherapeutic effect on stage IVB endometrial cancers is very low. We present a patient with stage IVB endometrial adenocarcinoma, whose tumor was not resected completely at the first surgery. She showed a remarkable response to a PEP (pirarubicin, etoposide, cisplatin) regimen and has survived without disease over 8 years. This case suggests that reduction surgery following PEP therapy is a new therapeutic modality for stage IVB endometrial carcinoma.

Topics: Adenocarcinoma; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Doxorubicin; Endometrial Neoplasms; Etoposide; Female; Humans; Middle Aged; Neoplasm Staging

Though the first choice of treatment for liver metastasis in colon cancer is surgical resection of liver, 30-60% of such patients experience a recurrence of liver metastasis. Even if reoperation is done optimally, the surgical resection of liver metastasis may not be a definitely curative treatment. For cases of liver metastasis from colon cancer that are non-resectable due to multiple liver metastases, other organ metastases (lung, bone, brain etc.), the advanced age of the patient, or other complications (cerebrovascular disease, diabetes mellitus, heart disease etc.), hepatic arterial infusion or systemic combination chemotherapies are selected. In the present paper, we report 3 cases of effective systemic chemotherapy utilizing CPT-11 for liver metastases from colon cancers. The method was UFT + irinotecan (CPT-11), cisplatin (CDDP) + tegafur + CPT-11, UFT + CPT-11 + etoposide (ETP) + pirarubicin (THP). The result obtained was a partial response (PR) in each case. As there were few adverse effects, we could provide treatment during a short-term admission or an outpatient basis. We thus obtained good post-chemotherapeutic QOL, and these regimens may be effective forms of chemotherapies in the future.

Topics: Adenocarcinoma; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Camptothecin; Cisplatin; Colonic Neoplasms; Doxorubicin; Drug Administration Schedule; Drug Evaluation; Etoposide; Female; Humans; Irinotecan; Liver Neoplasms; Male; Tegafur; Uracil

A 57-year-old female patient complained of atypical genital bleeding and a noxious emanation from her navel. A histological examination of the uterine body and the navel area confirmed a diagnosis of adenocarcinoma. We diagnosed it as IVb stage of uterine corpus cancer with a Sister Mary Joseph's nodule. We selectively administered intraarterial injection chemotherapy (Cisplatin 120 mg, Pirarubicin 40 mg) in the uterus and navel area (three times, once every three weeks) prior to surgery. The isolated uterus showed that the cancerous tissue had been eradicated, and we judged the cancer to be grade 3 following histopathological effective grading standards. The metastasis exhibited extreme shrinkage, but affirmed changes in the tumor quality. Currently, the patient is receiving maintenance therapy of 600 mg of Hysron H, and 600 mg of UFT. There are no indications of recurrence, and the patient is progressing well.

Topics: Abdominal Neoplasms; Adenocarcinoma; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Combined Modality Therapy; Doxorubicin; Female; Humans; Infusions, Intra-Arterial; Middle Aged; Remission Induction; Umbilicus; Uterine Neoplasms

In the preclinical study of a new combination therapy for gastric cancer, dFTP, consisting of doxifluridine (5'-DFUR), pirarubicin (THP) and cisplatin (DDP) as a modification of conventional FAP regimen (5-fluorouracil+Adriamycin+DDP), we compared antitumor and toxic effects of two sequential treatment schedules, single injection of DDP before or after 4 daily administrations of 5'-DFUR, on 5 strains of human gastric cancer bearing nude mice. Results indicated that both schedules of the dFTP regimen had potent antitumor effects. There was no significant difference between them. On the other hand, in terms of the host toxicity as observed by body weight loss, the post-DDP schedule was significantly less toxic than pre-DDP. These results suggest that dFTP regimen (post-DDP schedule) may be useful for clinical treatment of gastric cancers.

Topics: Adenocarcinoma; Animals; Antineoplastic Combined Chemotherapy Protocols; Body Weight; Cisplatin; Doxorubicin; Drug Administration Schedule; Female; Floxuridine; Humans; Mice; Mice, Nude; Neoplasm Transplantation; Stomach Neoplasms

We reported a patient with advanced gastric cancer and a liver metastasis, who responded remarkably to combination chemotherapy using THP, 5'-DFUR and CDDP. The patient was administered four courses of THP (15 mg/m2/day, on day 1, iv), 5'-DFUR (1400 mg/m2/day, on days 1-4 and 15-18, orally), and CDDP (80 mg/m2/day, on day 5, iv) every 4 weeks. As a result, both the primary and metastatic tumors decreased remarkably in size at more than 19 weeks (PR) and we performed curative total resection of the stomach and partial resection of the liver. Histologically, the effects of chemotherapy on gastric focus were evaluated as grade 1a and the liver metastasis completely disappeared. This combination therapy proved useful to treat advanced gastric cancer in this patient.

Topics: Adenocarcinoma; Aged; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Doxorubicin; Drug Administration Schedule; Floxuridine; Gastrectomy; Humans; Liver Neoplasms; Male; Stomach Neoplasms

A patient with navel metastasis from ovarian carcinoma was treated by immunotherapy and neo-adjuvant intraarterial infusion chemotherapy (OK-432 i.c., VP-16 25 mg/body x 10 days po, CDDP 100 mg/m2 iA, CPM 200 mg x 3 days/body i.v., THP 50 mg/m2 iA). Maximal blood concentration of THP was 1.081 micrograms/ml at 1 hour intraarterially and 0.091 microgram/ml at 2 hour intravenously. THP concentration of arteria is ten times higher than that of venous. And the area under the curve (AUC) of THP is 3.46 micrograms/ml/hr intraarterially and 0.43 microgram/ml/hr at intravenous. Two courses of the neo-adjuvant intraarterial chemotherapy were done. One month after, the first operation was performed. Each tissue platina concentration is 9.72 micrograms/ml is 9.72 micrograms/cm3 uterus cervix, 7.10 micrograms/cm3 uterus corporis, 5.72 micrograms/cm3 left ovarium, 2.64 micrograms/cm3 right ovarium, 0.52 microgram/cm3 paraaortic lymph node. After the immuno-chemotherapy, the metastatic tumor appeared remarkably smaller and the main tumor regained normal size and we achieved the optimal operation successfully. This patient was treated with double platina chemotherapy by intraperitoneal infusion using implantable reservoir access after the first operation (VP-16 200 mg/m2 i.p. D1, CDDP 100 mg/m2 ip D1, CBDCA 300 mg/m2 i.v. D3). This patient can keep the state of cytological complete remission for more than four months after the second look operation. Now she continues maintenance immuno-chemotherapy from a home doctor.

Topics: Adenocarcinoma; Adult; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Cyclophosphamide; Doxorubicin; Etoposide; Female; Humans; Immunotherapy; Infusion Pumps, Implantable; Neoplasm Staging; Ovarian Neoplasms; Picibanil; Remission Induction

A 67-year-old man with advanced gastric cancer with multiple liver metastases was treated by a new combination chemotherapy using 5-FU, THP and MMC (FTM). After the first course of FTM, both abnormal liver function and the elevated level of serum CA 19-9 were restored. After the second course of FTM, the primary lesion became a small ulcer around cardia. A partial response was recognized both in the primary lesion and in the liver metastases. No serious side effect was observed except for leukocytopenia, which was controlled by G-CSFS. This new combination chemotherapy (FTM) was suggested to be useful even for far advanced gastric cancer.

Topics: Adenocarcinoma; Aged; Antineoplastic Combined Chemotherapy Protocols; Doxorubicin; Drug Administration Schedule; Fluorouracil; Humans; Liver Neoplasms; Male; Mitomycin; Stomach Neoplasms

Topics: Adenocarcinoma; Adult; Aged; Antibiotics, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Cisplatin; Doxorubicin; Drug Administration Schedule; Etoposide; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged

Pirarubicin, a new antineoplastic antibiotic of anthracycline derivative, was injected into the pleural cavity in 15 patients with malignant pleural effusion. The dose of pirarubicin was 40 mg or 80 mg/body. All 15 patients were evaluable for both efficacy and toxicity. Since one evaluable patient received two courses of intrapleural administration of pirarubicin, we evaluated a total of 16 courses. Overall response rate was 81.3% with 7 CR cases, 6 PR cases and 3 NR cases. As toxicities, transient elevation of fever was observed in 81.3%, chest pain in 37.5%, appetite loss in 18.8%, nausea in 12.5% and bone marrow suppression in 6.3% of 16 courses, but no alopecia was observed. Between 40 mg group (n = 8) and 80 mg group (n = 8), no significant difference was observed in response rate, response duration, survival duration or toxicities except for fever. Fever over 38 degrees C was observed in all (100%) the 80 mg group, which was significantly higher than 50% in the 40 mg group. Response duration in cases with fever over 38 degrees C (n = 12) was significantly longer than in cases with maximum fever under 38 degrees C (n = 4). Intrapleural administration of pirarubicin was considered to be effective for the treatment of malignant pleural effusion without severe toxicities.

Topics: Adenocarcinoma; Adult; Aged; Anorexia; Carcinoma, Small Cell; Chest Pain; Doxorubicin; Female; Fever; Humans; Infusions, Parenteral; Lung Neoplasms; Middle Aged; Pleural Effusion, Malignant; Stomach Neoplasms; Survival Rate

Twelve patients with advanced or relapsed head and neck adenocarcinoma received a combination chemotherapy regimen of either cyclophosphamide (C), tetrahydropyranyl-adriamycin (T), and cis-platinum (P) (CTP) or cyclophosphamide, adriamycin (A), and cis-platinum (CAP). Cyclophosphamide (300 mg/sq m), either etrahydropyranyl-adriamycin (30 mg/sq m) or adriamycin (30 mg/sq m), and cis-platinum (50 mg/sq m) were administered intravenously in a single day. Nine patients received the CTP regimen, and three patients, the CAP regimen. Prior to chemotherapy, five patients had received surgery or radiation therapy, and the other seven patients received no special treatment. A response rate 75% was achieved (9/12); there were 7 complete responses, whose duration was a mean 6.8 months, ranging from 2 to 18 months, and 2 partial responses, whose duration was 2 months. Virtually all patients experienced nausea and vomiting. Alopecia developed in 7 patients; however, the patients with the CTP regimen experienced less alopecia, if any. Leucopenia and anemia of either a slight or moderate degree were observed, but there was no patient for whom it was necessary to discontinue the treatment. Both CTP and CAP regimens appear to be of significant value in controlling head and neck adenocarcinoma.

Topics: Adenocarcinoma; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Cyclophosphamide; Doxorubicin; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Neoplasm Recurrence, Local

Two patients with recurrent gastrointestinal carcinoma were treated with THP. Partial response was recognized in the local recurrent tumor of one patient and in liver metastasis of a second patient. THP was administered every three weeks at a dose of 60 mg per total body weight intravenously. The total dose of THP achieved was 720 mg in the first patient and 920 mg in the second. Despite the high dosage, neither cardiotoxicity nor alopecia was observed. These results suggest that the administration of THP may be efficacious and safe in the management of patients with recurrent gastrointestinal carcinoma.

Topics: Adenocarcinoma; Adult; Doxorubicin; Female; Humans; Injections, Intravenous; Liver Neoplasms; Male; Middle Aged; Neoplasm Recurrence, Local; Rectal Neoplasms; Stomach Neoplasms

One-day CAP therapy utilizing CPM, THP-ADM and CDDP was performed on 33 patients with malignant tumors in the head and neck region which were able to be evaluated. As a result, CR was obtained in 6 patients and PR in 11 patients; thus the overall response rate was 51.5%. The present therapy is worthwhile as a neo-adjuvant chemotherapy and it was effective in patients with relatively severe systemic condition or those with lung metastasis. When the tissues were classified histologically, the present therapy was effective against anaplastic carcinoma and adenocarcinoma. Since agents significantly effective against adenocarcinoma have not been available so far, the present therapy is considered to be a useful method especially for the treatment of adenocarcinoma. Moreover, because irreversible side effects scarcely appeared and because the period for 1 course of treatment is short enough, the present therapy is considered to be a method with little burden on patients.

Topics: Adenocarcinoma; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma; Carcinoma, Squamous Cell; Cisplatin; Cyclophosphamide; Doxorubicin; Female; Head and Neck Neoplasms; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Middle Aged

(2''R)-4'-O-Tetrahydropyranyladriamycin (THP), a new anthracycline antibiotic, showed stronger inhibition of the growth of L1210, CCMT (mouse mammary adenocarcinoma) and Yoshida sarcoma in rats than did adriamycin (ADM). The antitumor activity of THP against P388 and Meth-A (mouse fibrosarcoma) was equal or slightly superior to that of ADM. Moreover, THP was active against an ADM-resistant subline of P388. THP at the optimal effective dose against experimental tumors had no toxic effect on the cellular immune system in normal and tumor-bearing mice.

Topics: Adenocarcinoma; Animals; Antineoplastic Agents; Doxorubicin; Immunity, Cellular; Leukemia L1210; Leukemia P388; Male; Mammary Neoplasms, Experimental; Mice; Mice, Inbred Strains; Neoplasms, Experimental; Sarcoma, Yoshida

Chemotherapy with 4'-O-tetrahydropyranyladriamycin (THP-ADM), a new derivative of Adriamycin, was equally or more effective against several experimental mouse tumors than it was with Adriamycin (ADM). When mice with P388 leukemia were given i.p. injections of THP-ADM or ADM daily for 9 consecutive days, the maximum increases in life span (ILSs) of the mice were 190 and 175%, respectively. Eight of 24 mice treated with THP-ADM were free of tumor, while one of 24 mice treated with ADM was free of tumor. A single i.p. injection of either drug was also effective; maximum ILS was 170% for mice treated with THP-ADM and 240% for those treated with ADM. Nine of 12 mice were found to be free of tumor. THP-ADM was equally or slightly more effective against P388 leukemia than was ADM when either drug was given i.v. The maximum ILS was 106% with THP-ADM and 77% with ADM when the drug was given for 9 consecutive days. Single i.v. injections of THP-ADM or ADM were almost equally (ILS, 100%) effective. Chemotherapy with THP-ADM was also very effective against L1210 leukemia. THP-ADM administered i.p. five times, every other day starting from Day 1, was more effective than ADM was against Lewis lung carcinoma, B16 melanoma, and colon adenocarcinoma 38 inoculated s.c. In the study with Lewis lung carcinoma, metastasis to the lungs was well suppressed by THP-ADM. ADM was more effective than was THP-ADM against colon adenocarcinoma 26. Because THP-ADM was more cytotoxic than or almost equally as cytotoxic as ADM against the established cell lines from the above mouse tumors, we suggest that THP-ADM is more efficiently transported into cultured cells.

Topics: Adenocarcinoma; Animals; Antineoplastic Agents; Cell Line; Colonic Neoplasms; Doxorubicin; Leukemia P388; Lung Neoplasms; Melanoma; Mice; Mice, Inbred Strains; Neoplasms, Experimental