Cell kinetics and programmed chemotherapy for gynecologic cancer. I. Squamous-cell carcinoma

In vivo cell kinetic effects of cis-platinum on human ovarian cancer xenografts measured by dual parameter flow cytometry

Dual parameter flow cytometry, measuring DNA and nuclear protein of individual cell nuclei simultaneously, makes it possible to follow cell kinetic perturbations in six distinct compartments of the cell cycle following chemotherapy in vivo. Human ovarian cancer xenografts in nude mice from a primary and recurrent tumor of the same patient were studied. The response to intraperitoneal application of cis-platinum was assessed by tumor volume measurements, changes in labeling indices by autoradiography, and dual parameter flow cytometry. Sequential tissue samples were taken from each tumor using fine needle aspirations as a microbiopsy method. Pretherapy samples were compared to multiple specimens collected up to 18 days after therapy. Morphologic changes of each specimen were also assessed. Cis-platinum affects malignant cells in the G1B, S, G2A, and G2B compartments with various intensities and different time frames, depending on the drug sensitivity of each individual tumor.

In vivo chemosensitivity testing in patients with gynecologic malignancies and nude mouse xenografts by monitoring cell kinetic parameters and DNA distribution patterns: a preliminary report

Using flow cytometry (FCM) and autoradiography we have evaluated changes in DNA-ploidy patterns as well as cell-cycle perturbations after chemotherapy in 12 patients with accessible tumors and 22 nude mice xenografts. Gynecologic malignancies growing as nude mouse xenografts serve as an experimental model to study the effect of chemotherapy at the cellular level. Excellent correlation was found between fine needle aspiration (FNA) and biopsy material for either FCM or autoradiography. It now appears possible to study the effects of chemotherapy in the patient as well as the animal model using serial FNAs as a microsampling technique.

Proliferative pattern of urothelial bladder cancer and urothelial atypias

For early diagnosis of urinary bladder tumors, autoradiographic, cytological, and impulse cytophotometric examinations were performed on fresh bladder tissue with carcinomas of different grades of malignancy and various depths of infiltration, and also on tissues with concomitant urothelial atypias. Cell kinetic examinations of urothelial atypias of mild, moderate, and severe grade revealed labeling indices comparable to those of urothelial carcinomas grade I, II, and III, respectively. The labeling indices of the carcinomas increased with both the grades of malignancy and the depth of invasion up to factor 5. Cytophotometrically mild atypias showed euploidy, while moderate to severe atypias revealed aneuploidy. By means of cytologic, cytophotometric, and cell kinetic analyses, two subgroups of G I urothelial carcinomas were distinguished. Subgroup I a corresponded to highly differentiated papillary urothelial carcinomas with low labeling indices, pap I-III differentiation, and euploidy. Subgroup I b, on the other hand, revealed pap differentiations of IV-V, aneuploidy, and higher labeling indices. This subgroup seems to be more prone to recurrences and apparently indicates higher grades of malignancy and depths of infiltration. The data presented provide evidence that a combination of these methods is helpful for early recognition of precursors of bladder cancer atypias as well as for exact evaluation of the biological potential of carcinomas.

Phase II and pharmacokinetic study of high-dose methotrexate in the treatment of advanced gynecologic malignancy. A Southwest Oncology Group Trial

Fifteen patients with advanced or recurrent gynecologic malignancy were treated with high-dose methotrexate (HDMTX) (1-8 g/M2) and citrovorum factor rescue (10-100 mg/M2). One complete response (13%) and two improved responses occurred in eight patients (25%) with squamous cell carcinoma and one of seven patients (14%) with nonsquamous nontrophoblastic carcinoma had stable disease for 7 months. The median duration of survival in the squamous group was 9 months and in the nonsquamous groups 6.5 months. Mean serum MTX concentrations were proportional to the doses administered and typical two compartment plasma disappearance curves were seen. Adverse toxic reactions were not observed at serum MTX levels less than 7.8 X 10(-7) M at 24 hr and 1 X 10(-7) M at 48 hr post-MTX. Hematopoietic toxicity occurred most frequently with leukopenia observed in 19.5% of courses. Hepatic, renal, gastrointestinal, and dermatologic toxicities were observed infrequently. Drug-induced nephrotoxicity occurred in one patient and possibly related leukoencephalopathy occurred in another patient. On the basis of the relatively low response rate observed in this trial and the high expense of HDMTX therapy, the value of such therapy may be limited in advanced nontrophoblastic gynecologic cancer.

Epithelial cells kinetics. A review of methods of study and their application to oral mucosa in health and disease. Part B. Comparison of cell kinetics in normal and abnormal epithelia

In Part A, the techniques most commonly used to study epithelial cell kinetics and their suitability for use in man are reviewed. In Part B, the application of such methods to comparative studies of normal and abnormal oral epithelial of both man and experimental animals is examined. Claims regarding the possible prognostic value of LI's or MI's of biopsies of potentially or overtly malignant human oral lesions are also considered. Normal and abnormal kinetic data for other lining epithelia, e.g., skin, uterine cervix and gastrointestinal mucosa are assessed where they provide a better illustration of some of the problems arising in such comparative investigations. Finally, the present and likely future areas in which cell kinetic studies may provide a guide to expected tumour prognosis and optimum treatment are summarized.

Cell proliferation patterns in human malignant melanoma, in vivo

Cell kinetics were studied, in vivo, in 19 patients with metastatic melanoma by autoradiographic technics. Multiple tumor labeling indices (L.I.) were determined with intralesional H3-TdR in 19 patients and were correlated with the presence of melanin. Serial biopsies were obtained to derive percent labeled mitoses (PLM) curves for 9 individual patients. Duration of the S and G2 phases were calculated using 50 and 37% intercepts from the PLM curves, as well as by two computerized cell-cycle analysis programs, and the results were compared. Tumor L.I.s were found to be reproducible for distant metastases of similar size in the same patient. Tumor L.I.s had a bimodal distribution for the 19 patients examined. The two significantly distinct subgroups had L.I.s of 18.2 +/- 3.4% and 6.7 +/- 2.1%. The presence of melanin correlated with the higher L.I. subgroup. The difference in L.I. may reflect a higher growth fraction or a shorter germinative cycle in melanotic tumors. However, the presence of melanin did not correlate with a change in the duration of S or G2 phases. The sum of Ts and Tg2 was approximately 24 hours, regardless of the analytic method. These kinetic parameters are being monitored during chemotherapy for prognostic indicators.

Tumor antigen of human cervical squamous cell carcinoma: correlation of circulating levels with disease progress

A double-antibody radioimmunoassay method was used for serial determinations of a tumor-antigen (TA-4) of cervical squamous cell carcinoma, and the correlation of serum antigen levels with the disease progess was investigated in 23 patients with cervical squamous cell carcinoma. Ten cases with widespread metastases received radiotherapy and/or chemotherapy. Nine of these cases who showed progression of the disease had a corresponding increase in serum antigen levels, while one case who had regression of the disease showed a corresponding decrease in serum antigen levels. Thirteen patients received radical surgery, and in all of these, high pretreatment antigen levels declined to undetectable levels 1 or 2 weeks after surgery. A panel of coded sera from the NCI-Mayo Clinic Serum Bank was also studied for evaluating the specificity of the assay. Thirteen of 25 patients (52%) with cervical squamous cell carcinoma showed positive serum antigen levels, while only one of 58 control cases (1.7%) showed false-positive result. These results suggest that serial TA-4 determinations may provide a useful method for evaluating regression or progression of the disease.

Adriamycin alone or in combination in 100 patients with carcinoma of the cervix or vagina

One hundred consecutive evaluable patients with advanced carcinoma of the cervix or vagina were treated with doxorubicin (Adriamycin) alone or in combination. The use of Adriamycin in conjunction with cyclophosphamide and 5-fluorouracil resulted in the highest response rate with all responders continuing to respond.