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Siefker-Radtke AO, Necchi A, Park SH, García-Donas J, Huddart RA, Burgess EF, Fleming MT, Rezazadeh Kalebasty A, Mellado B, Varlamov S, Joshi M, Duran I, Tagawa ST, Zakharia Y, Akapame S, Santiago-Walker AE, Monga M, O'Hagan A, Loriot Y, Loriot Y, Park SH, Tagawa S, Flechon A, Alexeev B, Varlamov S, Huddart R, Burgess E, Rezazadeh A, Siefker-Radtke A, Vano Y, Gasparro D, Hamzaj A, Kopyltsov E, Gracia Donas J, Mellado B, Parikh O, Schatteman P, Culine S, Houédé N, Zanetta S, Facchini G, Scagliotti G, Schinzari G, Lee JL, Shkolnik M, Fleming M, Joshi M, O'Donnell P, Stöger H, Decaestecker K, Dirix L, Machiels JP, Borchiellini D, Delva R, Rolland F, Hadaschik B, Retz M, Rosenbaum E, Basso U, Mosca A, Lee HJ, Shin DB, Cebotaru C, Duran I, Moreno V, Perez Gracia JL, Pinto A, Su WP, Wang SS, Hainsworth J, Schnadig I, Srinivas S, Vogelzang N, Loidl W, Meran J, Gross Goupil M, Joly F, Imkamp F, Klotz T, Krege S, May M, Schultze-Seemann W, Strauss A, Zimmermann U, Keizman D, Peer A, Sella A, Berardi R, De Giorgi U, Sternberg CN, Rha SY, Bulat I, Izmailov A, Matveev V, Vladimirov V, Carles J, Font A, Saez M, Syndikus I, Tarver K, Appleman L, Burke J, Dawson N, Jain S, Zakharia Y. Efficacy and safety of erdafitinib in patients with locally advanced or metastatic urothelial carcinoma: long-term follow-up of a phase 2 study. Lancet Oncol 2022; 23:248-258. [PMID: 35030333 DOI: 10.1016/s1470-2045(21)00660-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Erdafitinib, a pan-fibroblast growth factor receptor (FGFR) tyrosine kinase inhibitor, was shown to be clinically active and tolerable in patients with advanced urothelial carcinoma and prespecified FGFR alterations in the primary analysis of the BLC2001 study at median 11 months of follow-up. We aimed to assess the long-term efficacy and safety of the selected regimen of erdafitinib determined in the initial part of the study. METHODS The open-label, non-comparator, phase 2, BLC2001 study was done at 126 medical centres in 14 countries across Asia, Europe, and North America. Eligible patients were aged 18 years or older with locally advanced and unresectable or metastatic urothelial carcinoma, at least one prespecified FGFR alteration, an Eastern Cooperative Oncology Group performance status of 0-2, and progressive disease after receiving at least one systemic chemotherapy or within 12 months of neoadjuvant or adjuvant chemotherapy or were ineligible for cisplatin. The selected regimen determined in the initial part of the study was continuous once daily 8 mg/day oral erdafitinib in 28-day cycles, with provision for pharmacodynamically guided uptitration to 9 mg/day (8 mg/day UpT). The primary endpoint was investigator-assessed confirmed objective response rate according to Response Evaluation Criteria In Solid Tumors version 1.1. Efficacy and safety were analysed in all treated patients who received at least one dose of erdafitinib. This is the final analysis of this study. This study is registered with ClinicalTrials.gov, NCT02365597. FINDINGS Between May 25, 2015, and Aug 9, 2018, 2328 patients were screened, of whom 212 were enrolled and 101 were treated with the selected erdafitinib 8 mg/day UpT regimen. The data cutoff date for this analysis was Aug 9, 2019. Median efficacy follow-up was 24·0 months (IQR 22·7-26·6). The investigator-assessed objective response rate for patients treated with the selected erdafitinib regimen was 40 (40%; 95% CI 30-49) of 101 patients. The safety profile remained similar to that in the primary analysis, with no new safety signals reported with longer follow-up. Grade 3-4 treatment-emergent adverse events of any causality occurred in 72 (71%) of 101 patients. The most common grade 3-4 treatment-emergent adverse events of any cause were stomatitis (in 14 [14%] of 101 patients) and hyponatraemia (in 11 [11%]). There were no treatment-related deaths. INTERPRETATION With longer follow-up, treatment with the selected regimen of erdafitinib showed consistent activity and a manageable safety profile in patients with locally advanced or metastatic urothelial carcinoma and prespecified FGFR alterations. FUNDING Janssen Research & Development.
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Affiliation(s)
- Arlene O Siefker-Radtke
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Andrea Necchi
- Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital and Scientific Institute, Milan, Italy
| | - Se Hoon Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jesús García-Donas
- Medical Oncology Department, Fundacion Hospital de Madrid and IMMA Medicine Faculty, San Pablo CEU University, Madrid, Spain
| | - Robert A Huddart
- Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Earle F Burgess
- Medical Oncology Department, Levine Cancer Institute, Charlotte, NC, USA
| | - Mark T Fleming
- Medical Oncology Department, Virginia Oncology Associates, US Oncology Research, Norfolk, VA, USA
| | | | - Begoña Mellado
- Medical Oncology Department, Hospital Clinic Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Sergei Varlamov
- Department of Urologic Oncology, Altai Regional Cancer Center, Barnaul, Russia
| | - Monika Joshi
- Department of Medicine, Penn State Cancer Institute, Hershey, PA, USA
| | - Ignacio Duran
- Department of Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Scott T Tagawa
- Division of Hematology and Medical Oncology, Weill Cornell Medical College, New York, NY, USA
| | - Yousef Zakharia
- Department of Internal Medicine, University of Iowa, Holden Comprehensive Cancer Center, Iowa City, IA, USA
| | | | | | - Manish Monga
- Janssen Research & Development, Spring House, PA, USA
| | - Anne O'Hagan
- Janssen Research & Development, Spring House, PA, USA
| | - Yohann Loriot
- Department of Cancer Medicine, INSERM U981, Gustave Roussy, Université Paris-Saclay, Villejuif, France
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Gillessen S, Omlin A, Attard G, de Bono JS, Efstathiou E, Fizazi K, Halabi S, Nelson PS, Sartor O, Smith MR, Soule HR, Akaza H, Beer TM, Beltran H, Chinnaiyan AM, Daugaard G, Davis ID, De Santis M, Drake CG, Eeles RA, Fanti S, Gleave ME, Heidenreich A, Hussain M, James ND, Lecouvet FE, Logothetis CJ, Mastris K, Nilsson S, Oh WK, Olmos D, Padhani AR, Parker C, Rubin MA, Schalken JA, Scher HI, Sella A, Shore ND, Small EJ, Sternberg CN, Suzuki H, Sweeney CJ, Tannock IF, Tombal B. Management of patients with advanced prostate cancer: recommendations of the St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) 2015. Ann Oncol 2019; 30:e3. [PMID: 27141017 DOI: 10.1093/annonc/mdw180] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Peer A, Kolin M, Rouvinov K, Keizman D, Sarid D, Leibowitz-Amit R, Berger R, Sella A, Rasco A, Rosenbaum E, Maurice-Dror C, Neumann A, Neiman V. Advanced treatment line (ATL) with lenvatinib and everolimus (Len+Eve) for metastatic renal cell carcinoma (mRCC): Analysis of a national early access program (EAP). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy283.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Peer A, Savion K, Rouvinov K, Leibowitz-Amit R, Berger R, Sella A, Neiman V, Rosenbaum E, Mermershtain W, Neumann A, Kolin M, Perets R, Keizman D. Patients (pts) with metastatic non-clear cell renal cell carcinoma (mnccRCC) treated with Nivolumab (Nivo) based immunotherapy as advanced treatment (ATL) line: analysis of a national early access program (EAP). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx371.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sella A, Kovel S, Sella T. PSA kinetics impact on CT-PET PSMA uptake in prostate cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx370.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Miller TS, Jorge AB, Suter TM, Sella A, Corà F, McMillan PF. Carbon nitrides: synthesis and characterization of a new class of functional materials. Phys Chem Chem Phys 2017; 19:15613-15638. [DOI: 10.1039/c7cp02711g] [Citation(s) in RCA: 247] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
We examine the characterization of carbon nitrides and provide a perspective on their functional properties as next-generation materials.
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Affiliation(s)
- T. S. Miller
- Department of Chemistry
- Christopher Ingold Building
- University College London
- London
- UK
| | - A. Belen Jorge
- Materials Research Institute
- School of Engineering and Materials Science
- Queen Mary University of London
- London
- UK
| | - T. M. Suter
- Department of Chemistry
- Christopher Ingold Building
- University College London
- London
- UK
| | - A. Sella
- Department of Chemistry
- Christopher Ingold Building
- University College London
- London
- UK
| | - F. Corà
- Department of Chemistry
- Christopher Ingold Building
- University College London
- London
- UK
| | - P. F. McMillan
- Department of Chemistry
- Christopher Ingold Building
- University College London
- London
- UK
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Neiman V, Keizman D, Sarid D, Lee JL, Sella A, Gottfried M, Hammers H, Eisenberger M, Carducci M, Sinibaldi V, Rosenbaum E, Peer A, Neumann A, Mermershtain W, Rouvinov K, Berger R, Yildiz I. Outcome of patients with metastatic chromophobe renal cell carcinoma treated with sunitinib. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw373.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Vrdoljak E, Torday L, Szczylik C, Kharkevich G, Bavbek S, Sella A. Pharmacoeconomic and clinical implications of sequential therapy for metastatic renal cell carcinoma patients in Central and Eastern Europe. Expert Opin Pharmacother 2015; 17:93-104. [PMID: 26619144 DOI: 10.1517/14656566.2016.1107043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION The incidence and mortality rates of kidney cancer in the Central and Eastern European (CEE) region are among the highest in the world. Access to second and subsequent lines of metastatic renal cell carcinoma (mRCC) therapies is highly varied in the region. Despite the increasing body of evidence supporting the clinical benefit of multiple lines of treatment, access to treatment beyond first line is restricted in many of these countries. AREAS COVERED The adoption of targeted therapies for the first-line treatment of mRCC in the region was slow and faced many obstacles. In order to evaluate the current status of treatment beyond the first-line setting in the CEE region, this review examines the availability and reimbursement of mRCC drugs and clinical practice in institutions that treat patients with mRCC. EXPERT OPINION This review highlights the need to raise awareness among physicians, payers and regulators on clinical trial and cost-effectiveness data regarding the treatment of mRCC beyond the first line. The obstacles to mRCC drug access highlighted in this review need to be overcome to ensure that patients are receiving the best treatment available.
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Affiliation(s)
- E Vrdoljak
- a University Hospital Split , Department of Oncology , Split , Croatia
| | - L Torday
- b University of Szeged , Department of Oncotherapy , Szeged , Hungary
| | - C Szczylik
- c Central Clinical Hospital , Department of Oncology, Military Institute of Medicine , Warsaw , Poland
| | - G Kharkevich
- d NN Blokhin Russian Cancer Research Center , Biotherapy Department , Moscow , Russia
| | - S Bavbek
- e VKV American Hospital , Div. Medical Oncology , Istanbul , Turkey
| | - A Sella
- f Assaf Harofeh Centre Zerifin, Department of Oncology , Sackler School of Medicine, Tel Aviv University , Tel Aviv , Israel
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Gillessen S, Omlin A, Attard G, de Bono JS, Efstathiou E, Fizazi K, Halabi S, Nelson PS, Sartor O, Smith MR, Soule HR, Akaza H, Beer TM, Beltran H, Chinnaiyan AM, Daugaard G, Davis ID, De Santis M, Drake CG, Eeles RA, Fanti S, Gleave ME, Heidenreich A, Hussain M, James ND, Lecouvet FE, Logothetis CJ, Mastris K, Nilsson S, Oh WK, Olmos D, Padhani AR, Parker C, Rubin MA, Schalken JA, Scher HI, Sella A, Shore ND, Small EJ, Sternberg CN, Suzuki H, Sweeney CJ, Tannock IF, Tombal B. Management of patients with advanced prostate cancer: recommendations of the St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) 2015. Ann Oncol 2015; 26:1589-604. [PMID: 26041764 PMCID: PMC4511225 DOI: 10.1093/annonc/mdv257] [Citation(s) in RCA: 234] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 05/26/2015] [Accepted: 05/28/2015] [Indexed: 12/18/2022] Open
Abstract
The first St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) Expert Panel identified and reviewed the available evidence for the ten most important areas of controversy in advanced prostate cancer (APC) management. The successful registration of several drugs for castration-resistant prostate cancer and the recent studies of chemo-hormonal therapy in men with castration-naïve prostate cancer have led to considerable uncertainty as to the best treatment choices, sequence of treatment options and appropriate patient selection. Management recommendations based on expert opinion, and not based on a critical review of the available evidence, are presented. The various recommendations carried differing degrees of support, as reflected in the wording of the article text and in the detailed voting results recorded in supplementary Material, available at Annals of Oncology online. Detailed decisions on treatment as always will involve consideration of disease extent and location, prior treatments, host factors, patient preferences as well as logistical and economic constraints. Inclusion of men with APC in clinical trials should be encouraged.
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Affiliation(s)
- S Gillessen
- Department of Oncology/Haematology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - A Omlin
- Department of Oncology/Haematology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - G Attard
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - J S de Bono
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - E Efstathiou
- Department of Genitourinary Medical Oncology, MD Anderson Cancer Centre, Houston Department of Genitourinary Medical Oncology, David H. Koch Centre, The University of Texas M. D. Anderson Cancer Centre, Houston, USA Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - K Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Sud, Villejuif, France
| | - S Halabi
- Department of Biostatistics and Bioinformatics, Duke University, Durham
| | - P S Nelson
- Division of Human Biology, Fred Hutchinson Cancer Research Centre, Seattle
| | - O Sartor
- Tulane Cancer Centre, Tulane University, New Orleans
| | - M R Smith
- Massachusetts General Hospital Cancer Centre, Boston
| | - H R Soule
- Prostate Cancer Foundation, Santa Monica, USA
| | - H Akaza
- Research Centre for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - T M Beer
- Oregon Health & Science University Knight Cancer Institute, Portland
| | - H Beltran
- Department of Medicine, Weill Cornell Medical College, New York
| | - A M Chinnaiyan
- Michigan Centre for Translational Pathology, Department of Pathology Department of Urology, Comprehensive Cancer Centre Howard Hughes Medical Institute, University of Michigan Medical School, Ann Arbor, USA
| | - G Daugaard
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - I D Davis
- Monash University and Eastern Health, Eastern Health Clinical School, Box Hill, Australia
| | - M De Santis
- Cancer Research Centre, University of Warwick, Warwick, UK Ludwig Boltzmann Institute for Applied Cancer Research, Kaiser Franz Josef-Spital, Vienna, Austria
| | - C G Drake
- Johns Hopkins Sidney Kimmel Cancer Center and The Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - R A Eeles
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - S Fanti
- Department of Nuclear Medicine, Policlinico S. Orsola, University of Bologna, Bologna, Italy
| | - M E Gleave
- Urological Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada
| | - A Heidenreich
- Klinik und Poliklinik für Urologie, RWTH University Aachen, Aachen, Germany
| | - M Hussain
- University of Michigan Comprehensive Cancer Center, Ann Arbor, USA
| | - N D James
- Cancer Research Centre, University of Warwick, Warwick, UK Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham, Birmingham, UK
| | - F E Lecouvet
- Department of Radiology, Centre du Cancer et Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - C J Logothetis
- Department of Genitourinary Medical Oncology, MD Anderson Cancer Centre, Houston Department of Genitourinary Medical Oncology, David H. Koch Centre, The University of Texas M. D. Anderson Cancer Centre, Houston, USA
| | - K Mastris
- Europa Uomo Prostate Patients, Clayhall Ilford, UK
| | - S Nilsson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - W K Oh
- Division of Haematology and Medical Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - D Olmos
- Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid CNIO-IBIMA Genitourinary Cancer Unit, Hospitales Universitarios Virgen de la Victoria y Regional de Málaga, Málaga Centro Integral Oncológico Clara Campal (CIOCC), Madrid, Spain
| | - A R Padhani
- Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood
| | - C Parker
- Prostate Cancer Targeted Therapy Group, Academic Urology Unit and Department of Diagnostic Radiology, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - M A Rubin
- Institute for Precision Medicine, Meyer Cancer Center, Department of Pathology and Urology, Weill Cornell Medical College and NewYork Presbyterian, New York, USA
| | - J A Schalken
- Department of Urology, Radboud University, Medical Centre, Nijmegen, The Netherlands
| | - H I Scher
- Department of Medicine, Weill Cornell Medical College, New York Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York
| | - A Sella
- Department of Oncology, Assaf Harofeh Medical Centre, Tel-Aviv University, Sackler School of Medicine, Zerifin, Israel
| | - N D Shore
- Department of Urology, Carolina Urologic Research Centre, Myrtle Beach
| | - E J Small
- Helen Diller Family Comprehensive Cancer Centre, UCSF, San Francisco, USA
| | - C N Sternberg
- Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy
| | - H Suzuki
- Department of Urology, Toho University Sakura Medical Center, Chiba, Japan
| | - C J Sweeney
- Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - I F Tannock
- Department of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - B Tombal
- Service D'Urologie, Institut de Recherche Clinique, Université Catholique de Louvain, Brussels, Belgium
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Vrdoljak E, Torday L, Sella A, Leyman S, Bavbek S, Kharkevich G, Mardiak J, Szczylik C, Znaor A, Wilking N. Insights into cancer surveillance in Central and Eastern Europe, Israel and Turkey. Eur J Cancer Care (Engl) 2013; 24:99-110. [PMID: 24661376 DOI: 10.1111/ecc.12149] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2013] [Indexed: 11/28/2022]
Abstract
The current cancer landscape within transitional economies in central and Eastern Europe and the Mediterranean area is not particularly optimistic. Current perceptions are often based on extrapolations from other countries and regions; and hence the authors collaborated with the South Eastern Europe Oncology Group (SEEROG) to collect information on cancer registration in Central and Eastern Europe, Israel and Turkey. Healthcare authorities and specialist oncology centres in 21 countries in the region were contacted for information on cancer registries in their countries. Based on this information, the authors believe that the recording and reporting of data on cancer in the region is at an acceptable level. The authors discuss and compare institution- and population-based registries, and present opinions on elements of an 'ideal registry' based on the survey replies and comparisons with other registries. A comparison with the sources used for GLOBOCAN 2008 illustrates the need for consistent data to be communicated, published and utilised throughout the region and the oncology community. The authors conclude by considering the potential value of collaboration between health authorities across the region, as well as between the clinical and epidemiological communities, to ensure that cancer data are consistently collected, verified and made public.
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Affiliation(s)
- E Vrdoljak
- Center of Oncology, Clinical Hospital Split, Split, Croatia
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Sella A, Sella T, Kovel S. The Effect of Neutrophil to Lymphocyte Ratio (NLR) Prior to Taxotere-Based Chemotherapy in Patients (PT'S) with Metastatic Castration Resistant Prostate Cancer (MCRPC). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33511-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Bachner M, Loriot Y, Gross-Goupil M, Zucali PA, Horwich A, Germa-Lluch JR, Kollmannsberger C, Stoiber F, Fléchon A, Oechsle K, Gillessen S, Oldenburg J, Cohn-Cedermark G, Daugaard G, Morelli F, Sella A, Harland S, Kerst M, Gampe J, Dittrich C, Fizazi K, De Santis M. 2-¹⁸fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) for postchemotherapy seminoma residual lesions: a retrospective validation of the SEMPET trial. Ann Oncol 2012; 23:59-64. [PMID: 21460378 DOI: 10.1093/annonc/mdr052] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND 2-¹⁸fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) has been recommended in international guidelines in the evaluation of postchemotherapy seminoma residuals. Our trial was designed to validate these recommendations in a larger group of patients. PATIENTS AND METHODS FDG-PET studies in patients with metastatic seminoma and residual masses after platinum-containing chemotherapy were correlated with either the histology of the resected lesion(s) or the clinical outcome. RESULTS One hundred and seventy seven FDG-PET results were contributed. Of 127 eligible PET studies, 69% were true negative, 11% true positive, 6% false negative, and 15% false positive. We compared PET scans carried out before and after a cut-off level of 6 weeks after the end of the last chemotherapy cycle. PET sensitivity, specificity, negative predictive value (NPV), and positive predictive value were 50%, 77%, 91%, and 25%, respectively, before the cut-off and 82%, 90%, 95%, and 69% after the cut-off. PET accuracy significantly improved from 73% before to 88% after the cut-off (P=0.032). CONCLUSION Our study confirms the high specificity, sensitivity, and NPV of FDG-PET for evaluating postchemotherapy seminoma residuals. When carried out at an adequate time point, FDG-PET remains a valuable tool for clinical decision-making in this clinical setting and spares patients unnecessary therapy.
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Affiliation(s)
- M Bachner
- ACR-ITR VIEnna/CEADDP, LBI-ACR VIEnna, and KFJ-Spital, Vienna, Austria
| | - Y Loriot
- Institut Gustave Roussy, Villejuif, France
| | | | - P A Zucali
- Istituto Clinico Humanitas IRCCS, Rozzano (Milan), Italian Germ Cell Cancer Group
| | - A Horwich
- The Royal Marsden Hospital, London and Surrey, UK
| | | | | | - F Stoiber
- Krankenhaus der Barmherzigen Schwestern, Linz, Austria
| | | | - K Oechsle
- Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - S Gillessen
- Kantonsspital St. Gallen, St. Gallen, Switzerland
| | | | - G Cohn-Cedermark
- Department of Oncology-Pathology, Karolinska Institute and University Hospital, Stockholm, Sweden
| | - G Daugaard
- Department of Oncology, 5073 Rigshospitalet, Copenhagen, Denmark
| | - F Morelli
- Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - A Sella
- Assaf Harofeh Medical Center, Zerifin, Israel
| | - S Harland
- University College Hospital London, London, UK
| | - M Kerst
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J Gampe
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - C Dittrich
- ACR-ITR VIEnna/CEADDP, LBI-ACR VIEnna, and KFJ-Spital, Vienna, Austria
| | - K Fizazi
- Institut Gustave Roussy, Villejuif, France
| | - M De Santis
- ACR-ITR VIEnna/CEADDP, LBI-ACR VIEnna, and KFJ-Spital, Vienna, Austria.
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Hussain M, Smith MR, Sweeney C, Corn PG, Elfiky A, Gordon MS, Haas NB, Harzstark AL, Kurzrock R, Lara P, Lin C, Sella A, Small EJ, Spira AI, Vaishampayan UN, Vogelzang NJ, Scheffold C, Ballinger MD, Schimmoller F, Smith DC. Cabozantinib (XL184) in metastatic castration-resistant prostate cancer (mCRPC): Results from a phase II randomized discontinuation trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4516] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Buckanovich RJ, Berger R, Sella A, Sikic BI, Shen X, Ramies DA, Smith DC, Vergote IB. Activity of cabozantinib (XL184) in advanced ovarian cancer patients (pts): Results from a phase II randomized discontinuation trial (RDT). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.5008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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15
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Quesada Cabrera R, Sella A, Bailey E, Leynaud O, McMillan P. High-pressure synthesis and structural behavior of sodium orthonitrate Na3NO4. J SOLID STATE CHEM 2011. [DOI: 10.1016/j.jssc.2011.02.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Vergote I, Sella A, Bedell C, Ramondetta L, Shapiro G, Balic K, Prokopczuk E, Sauer L, Tseng L, Berger R. 407 Phase 2 study of XL184 in a cohort of ovarian cancer patients (pts) with measurable soft tissue disease. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)72114-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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17
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Giralt SA, Dexeus F, Amato R, Sella A, Logothetis C. Hyperthyroidism in men with germ cell tumors and high levels of beta-human chorionic gonadotropin. Cancer 2010; 69:1286-90. [PMID: 1371235 DOI: 10.1002/cncr.2820690535] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A retrospective review was done on all high volume choriocarcinomas and other germ cell tumors of men with serum beta-human chorionic gonadotropin (beta-HCG) levels greater than 50,000 mIU/ml to determine the incidence and characteristics of hyperthyroidism in this setting. Nineteen patients were identified with high beta-HCG levels, but because 2 did not have thyroid function tests performed, the cases of only 17 patients were evaluable. Of these, 14 (82%) had primary testicular carcinoma and 3 (18%) had extragonadal tumors. Beta-HCG levels on presentation ranged from 80,000 to 3,058,000 mIU/ml, with a median of 243,500 mIU/ml. Seven of the 17 evaluable cases (41%) had T4 serum levels higher than 12 micrograms/dl (normal level 4 to 12 micrograms/dl) with a median value of 15.4 micrograms/dl (range, 12.6 to 33.5 micrograms/dl); serum T4 levels correlated with beta-HCG levels (r = 0.84). All seven patients with elevated T4 levels had beta-HCG values greater than 200,000 mIU/ml, and three of these seven had clinical manifestations that could be attributed to an elevated serum T4; only one patient required specific antithyroid treatment; and after control of primary disease, all other patients had normalization of thyroid function. The most common manifestations of hyperthyroidism in our series were tachycardia, hypertension, and a systolic flow murmur; none of the patients had thyroid gland enlargement. We conclude that subclinical hyperthyroidism is a relatively common phenomenon in germ cell tumors of men with high levels of beta-HCG and that control of the primary disease results in serum T4 level normalization.
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Affiliation(s)
- S A Giralt
- Department of Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston 77030
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18
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Schwarz P, Calveira J, Sella A, Bessa M, Barcellos D, Cardoso M. Salmonella enterica: isolamento e soroprevalência em suínos abatidos no Rio Grande do Sul. ARQ BRAS MED VET ZOO 2009. [DOI: 10.1590/s0102-09352009000500003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Estudou-se a prevalência de Salmonella spp. em suínos ao abate e compararam-se os resultados obtidos no isolamento e na sorologia de modo a determinar a fase mais importante de infecção (granja ou transporte/espera pré-abate) em relação ao número de suínos portadores encontrados ao abate. Foram avaliados 40 rebanhos de três diferentes empresas do sul do Brasil, com colheitas de sangue e linfonodos mesentéricos de 20 animais por lote. O soro foi submetido ao ELISA produzido com antígeno somático de Salmonella Typhimurium. A frequência de isolamento variou de 62,5% a 85,0%, enquanto a soroprevalência de 73,8% a 83,2% nos três sistemas amostrados. Os sorovares mais prevalentes foram Agona, Typhimurium e Panama. A infecção dos animais ocorreu nas granjas produtoras de suínos nestes sistemas de produção, pois os lotes apresentaram elevada soroprevalência ao abate. Concluiu-se que o controle da infecção por Salmonella spp. no sul do Brasil deve iniciar-se pela implementação de medidas de profilaxia nas granjas de produção de suínos.
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19
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Sella A, Yarom N, Zisman A, Kovel S. Paclitaxel, estramustine and carboplatin combination chemotherapy after initial docetaxel-based chemotherapy in castration-resistant prostate cancer. Oncology 2009; 76:442-6. [PMID: 19420966 DOI: 10.1159/000217264] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2008] [Accepted: 09/22/2008] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Management of castration-resistant prostate cancer after docetaxel has become an unmet need for which various agents have been investigated. We report our experience with a paclitaxel-based regimen. METHODS From February 2004 to November 2007, 15 patients (PTS) received paclitaxel 80 mg/m(2) weekly on day 1, carboplatin (AUC = 6) on day 1 every 21 days and estramustine 140 mg on days -1, 0 and 1 every week. RESULTS Patient characteristics are: median age 67 years (range 44-81), median performance status (Eastern Cooperative Oncology Group) 1 (range 0-2) and median prostate-specific antigen 67.5 ng/ml (range 1.5-480). All PTS had soft-tissue and 12 (80%) also had osseous disease. A >50% decrease in prostate-specific antigen levels occurred in 9 PTS (60%, 95% CI 32-84). Responses included a partial response in 6 (40%, 95% CI 16-68) and stable disease in 5 PTS (33%). Median duration of progression-free survival was 4.0 months (range 1.1-13) and median survival was 14.6 months. After a median of 4 cycles (range 1-7), significant toxicity included fatigue grade 3 in 2 PTS (13%), neuropathy grade 2 and grade 4 in 1 patient each, and a single episode of grade 3 edema. Myelosuppression was mild. Two PTS (13%) had urinary tract infection and 1 patient neutropenic fever. One patient died due to brain hemorrhage. CONCLUSIONS Administration of second-line paclitaxel-based chemotherapy after docetaxel therapy is active in PTS with castration-resistant prostate cancer. This regimen is too toxic for palliative therapy. Careful patient selection is needed when this regimen is considered for therapy in these PTS.
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Affiliation(s)
- A Sella
- Department of Oncology, Assaf Harofeh Medical Center, Zerifin, Israel.
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20
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Sternberg CN, Dumez H, Van Poppel H, Skoneczna I, Sella A, Daugaard G, Gil T, Graham J, Carpentier P, Calabro F, Collette L, Lacombe D. Docetaxel plus oblimersen sodium (Bcl-2 antisense oligonucleotide): an EORTC multicenter, randomized phase II study in patients with castration-resistant prostate cancer. Ann Oncol 2009; 20:1264-9. [PMID: 19297314 DOI: 10.1093/annonc/mdn784] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND This randomized, phase II study assessed the activity of oblimersen sodium, a Bcl-2 antisense oligonucleotide, administered before docetaxel (Taxotere) to patients with castration-resistant prostate cancer. PATIENTS AND METHODS Chemotherapy-naive patients with prostate-specific antigen (PSA) progression and testosterone < or = 0.5 ng/ml received docetaxel 75 mg/m2 on day 1 or oblimersen 7 mg/kg/day continuous i.v. infusion on days 1-7 with docetaxel 75 mg/m2 on day 5 every 3 weeks for < or = 12 cycles. Primary end points were confirmed PSA response (Bubley criteria) and major toxic events. RESULTS Confirmed PSA response was observed in 46% and 37% of 57 and 54 patients treated with docetaxel and docetaxel-oblimersen, respectively. Partial response (RECIST) was achieved in 18% and 24%, respectively. Oblimersen added to docetaxel was associated with an increase in the incidence of grade > or = 3 fatigue, mucositis, and thrombocytopenia. Major toxic events were reported in 22.8% and 40.7% of patients with docetaxel and docetaxel-oblimersen, respectively. CONCLUSIONS The primary end points of the study were not met: a rate of confirmed PSA response >30% and a major toxic event rate <45% were not observed with docetaxel-oblimersen.
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Affiliation(s)
- C N Sternberg
- Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy.
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21
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Pappo I, Karni T, Sandbank J, Dinur I, Sella A, Stahl-Kent V, Wasserman I, Halevy A. Breast cancer in the elderly: histological, hormonal and surgical characteristics. Breast 2007; 16:60-7. [PMID: 17276293 DOI: 10.1016/j.breast.2006.05.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2006] [Revised: 05/16/2006] [Accepted: 05/21/2006] [Indexed: 11/26/2022] Open
Abstract
The characteristics, menstrual risk factors and surgical therapy of 187 consecutive patients more than 70 years of age (mean: 75.9) were investigated and compared with those of 609 patients less than 70 years of age (mean: 53.9). There was no difference in stage, size, state of axillary nodes, grade, histological types, Ki-67, vascular invasion, estrogen receptor rate, and HER-2/neu (+) rate. Positive progesterone receptor rate was higher in older patients (54.7% vs. 63.1%). Tumors were larger (p=0.01) and their stage higher (p=0.014) in patients more than 80 years of age. All menstrual risk factors were similar in the two groups. Positive familial history was more frequent in patients <60 years. Significantly more young patients used hormone replacement therapy (HRT) (21.8 vs. 8.6%). Older patients underwent less breast-conserving surgery (36.1 vs. 55.1%), and less axillary lymph node dissection (ALND) (69.7 vs. 84.9%). We conclude that breast cancer characteristics and menstrual risk factors are similar in the two age groups.
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Affiliation(s)
- I Pappo
- Comprehensive Breast Care Institute, Assaf Harofeh Medical Center, Zerifin 70300, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel.
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22
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Gross DJ, Munter G, Bitan M, Siegal T, Gabizon A, Weitzen R, Merimsky O, Ackerstein A, Salmon A, Sella A, Slavin S. The role of imatinib mesylate (Glivec) for treatment of patients with malignant endocrine tumors positive for c-kit or PDGF-R. Endocr Relat Cancer 2006; 13:535-40. [PMID: 16728580 DOI: 10.1677/erc.1.01124] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Imatinib mesylate (IM), a small molecule that is a selective inhibitor of the ABL, platelet derived growth factor receptor (PDGFR-R) and stem cell ligand receptor (c-kit) tyrosine kinases (TK). IM was also found to inhibit the TK activity of BCR/ABL fusion protein produced in chronic myelogenous leukemia, with marked clinical activity against the disease. Since both PDGF-R and c-kit both having a putative role in tumorigenesis, we investigated the efficacy and safety of the use of IM in patients with endocrine tumors unresponsive to conventional therapies that expressed c-kit and/or PDGF-R (within the framework of a comprehensive phase II multi-center study of IM in patients with solid tumors). IM was initiated at a dose of 400 mg/day, with possible dose escalation within 1 week to 600 mg/day and an option to raise the dose to 800 mg/day in the event of progression and in the absence of safety concerns for a period of up to 12 months. Between September 2002 and July 2003, 15 adult patients with disseminated endocrine tumors were recruited as follows: medullary thyroid carcinoma (MTC, n = 6); adrenocortical carcinoma (ACC, n = 4); malignant pheochromocytoma (pheo, n = 2); carcinoid (non-secreting, n = 2), neuroendocrine tumor (NET, n = 1). No objective responses were observed. MTC--disease progression in 4 patients, and treatment discontinuation in 2 patients due to adverse events; ACC--disease progression in 3 patients, and treatment discontinuation in 1 patient due to severe psychiatric adverse event; Pheo--disease progression in 2 patients; Carcinoid--stable disease in 1 patient (6.5 months), and disease progression in 1 patient; NET--disease progression in 1 patient. IM does not appear to be useful for treatment of malignant endocrine tumors, also causing significant toxicity in this patient population.
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Affiliation(s)
- David J Gross
- Endocrinology and Metabolism Service, Department of Medicine, Hadassah University Hospital, P.O.B 12000, Jerusalem, Israel 91120.
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Margel D, Tal R, Neuman A, Konichezky M, Sella A, Baniel J. Prediction of Extravesical Disease by Preoperative Serum Markers in Patients With Clinically Organ Confined Invasive Bladder Cancer. J Urol 2006; 175:1253-7; discussion 1257. [PMID: 16515972 DOI: 10.1016/s0022-5347(05)00699-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2004] [Indexed: 11/26/2022]
Abstract
PURPOSE We assessed the value of preoperative levels of CEA, CA-125 or CA 19-9 in patients with clinically organ confined bladder cancer to predict pathological extravesical and/or node positive disease. MATERIALS AND METHODS Serum levels of CEA, CA-125 and CA 19-9 were measured prospectively in all patients scheduled for cystectomy for clinically organ confined bladder cancer between September 1999 and May 2004. Biomarker expression was compared between patients with pathologically organ confined disease (pT2 or less, pN0) and patients with extravesical disease (greater than pT2, or pN1 or greater), and between patients with pathologically node negative (any pT, pN0) and node positive disease (any pT, pN1 or greater). RESULTS Of the 91 patients enrolled, 46 had (51%) pathologically organ confined tumors, 45 (49%) had extravesical disease and 17 (19%) had positive lymph nodes. Preoperative serum levels of all markers were significantly higher in cases of extravesical disease than in organ confined disease. On multivariate analysis CEA with an odds ratio of 8.6 (95% CI 1.51-48.6) and CA-125 with an OR of 29.5 (95% CI 3.6-242.6) proved independent predictors of extravesical disease. CA-125 and CA 19-9 levels were significantly higher in patients with node positive disease than in those with node negative disease. On multivariate analysis CA-125 with an OR of 22.2 (95% CI 3.8-129) and CA 19-9 with an OR of 5.2 (95% CI 1.09-24.76) proved independent predictors of node positive disease. CONCLUSIONS Increase in serum tumor markers before cystectomy in patients with clinically organ confined muscle invasive bladder cancer is a strong indicator of the presence of extravesical and node positive disease.
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Affiliation(s)
- David Margel
- Institute of Urology, Rabin Medical Center - Beilinson Campus, Petach Tikva, Israel.
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24
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Cyjon A, Rakowsky E, Sella A. P-204 Isolated mediastinal recurrence following primary treatment of non-small cell lung cancer: Curative or palliative approach? Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80698-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Hardy B, Raiter A, Rubin M, Sprecher E, Sella A, Flex D, Lelcuk S, Bsharah B, Mishaeli M, Niv Y. Cancer disease predictive diagnosis: BAT/CD3-positive lymphocytes in cancer patients. Int J Oncol 2005; 26:971-5. [PMID: 15753991 DOI: pmid/15753991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BAT is an immune-activating monoclonal antibody produced against Daudi cell membranes and selected for stimulating lymphocyte proliferation. The anti-tumor activity of BAT is related to its immunostimulatory properties. Both T and NK cells mediate the anti-tumor activity of BAT. CD4-positive T cells respond to BAT activation by proliferation and INF-gamma production. The aim of the study was to assess the probability that the BAT monoclonal antibody binding capacity to T cells is a marker for different cancers. Human peripheral blood T cells from colon, breast and prostate cancer patients, as well as healthy volunteer donors, were tested for the percentage of binding to BAT mAb (BAT/CD3 cells) by FACS analysis. All patients were tested before undergoing surgery or treatment, and their diagnosis was confirmed by histology. The results showed that the percentage of BAT monoclonal antibody binding to CD3-positive T cells in the peripheral blood was different in cancer patients with diverse tumor types. We found that lymphocytes from the blood of healthy donors contained 25% BAT/CD3 cells. In colon and breast cancer patients, a significant decrease to 13 and 11% of BAT/CD3 cells was found. In contrast, these cells increased ><50% in patients with prostate cancer. These findings may have a potential diagnostic significance and also assist in the evaluation of strategies for the therapeutic use of BAT for different cancer patients.
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Affiliation(s)
- Britta Hardy
- Felsenstein Medical Research Center, Rabin Medical Center-Beilinson Campus, Petah Tikva 49100, Israel.
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Margel D, Margel D, Tal R, Neuman A, Konichezky M, Sella A, Baniel J. 1372: Prediction of Extra Vesical Disease by Preoperative Serum Markers in Patients with Clinically Organ Confined Invasive Bladder Cancer. J Urol 2005. [DOI: 10.1016/s0022-5347(18)35506-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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27
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Hardy B, Raiter A, Rubin M, Sprecher E, Sella A, Flex D, Lelcuk S, Bsharah B, Mishaeli M, Niv Y. Cancer disease predictive diagnosis: BAT/CD3-positive lymphocytes in cancer patients. Int J Oncol 2005. [PMID: 15753991 DOI: 10.3892/ijo.26.4.971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BAT is an immune-activating monoclonal antibody produced against Daudi cell membranes and selected for stimulating lymphocyte proliferation. The anti-tumor activity of BAT is related to its immunostimulatory properties. Both T and NK cells mediate the anti-tumor activity of BAT. CD4-positive T cells respond to BAT activation by proliferation and INF-gamma production. The aim of the study was to assess the probability that the BAT monoclonal antibody binding capacity to T cells is a marker for different cancers. Human peripheral blood T cells from colon, breast and prostate cancer patients, as well as healthy volunteer donors, were tested for the percentage of binding to BAT mAb (BAT/CD3 cells) by FACS analysis. All patients were tested before undergoing surgery or treatment, and their diagnosis was confirmed by histology. The results showed that the percentage of BAT monoclonal antibody binding to CD3-positive T cells in the peripheral blood was different in cancer patients with diverse tumor types. We found that lymphocytes from the blood of healthy donors contained 25% BAT/CD3 cells. In colon and breast cancer patients, a significant decrease to 13 and 11% of BAT/CD3 cells was found. In contrast, these cells increased ><50% in patients with prostate cancer. These findings may have a potential diagnostic significance and also assist in the evaluation of strategies for the therapeutic use of BAT for different cancer patients.
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Affiliation(s)
- Britta Hardy
- Felsenstein Medical Research Center, Rabin Medical Center-Beilinson Campus, Petah Tikva 49100, Israel.
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Sella A, Schnider D, Kovel S, Shapira E, Halperin R, Wallach N, Fishman A. 187 The role of 3rd therapy in recurrent ovarian carcinoma or primary peritoneal carcinoma. EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)90220-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Affiliation(s)
- D Leibovici
- Department of Urology, Assaf-Harofeh Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Zerifin, 70300, Israel
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Mattei M, Carnieri E, Politi V, D'Alessio S, Sella A, Cassol M, Robeva A, Colizzi V, Sumerska T. Inhibition of contact hypersensitivity reaction to picryl chloride: effect of small molecular weight peptidomimetic compounds possessing inhibitory activity against metalloproteinases. Int Immunopharmacol 2002; 2:699-710. [PMID: 12013508 DOI: 10.1016/s1567-5769(02)00005-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We have studied the effect of small molecular weight inhibitors of snake venom metalloproteinases (SVMP) and matrix metalloproteinases (MMPs) on the induction and effector phase of the contact hypersensitivity reaction (CHR) in a mouse model. Identification of nonsteroid small molecules is very important for the development of new anti-inflammatory drugs. The compounds that we tested were synthetically modified tripeptides (peptidomimetic compounds) POL-257, POL-509, POL-443, POL-491, and POL-647, with structures based on natural occurring peptides in snake venom. A well-known hydroxamate-based inhibitor of the MMPs, Batimastat (BB-94), was also used. We have shown that these peptidomimetics possess in vitro inhibitory activity against the MMP-2 (gelatinase-A), MMP-9 (gelatinase-B), and MMP-3 (stromelysin). They also inhibit metalloproteinases purified from the venom of Crotalus adamanteus and C. atrox snakes, which are very similar to the so-called A Desintegrine, A Metalloproteinase (ADAMs) enzymes. When injected intraperitonealy before the topical application of the contact sensitizer (picryl chloride) or before the challenge, these compounds significantly inhibited the development of CHR. BB-94 at doses 0.4 and 4 mg/kg before the sensitization or before the challenge almost completely abrogated the reaction. POL-257 and POL-443 were among the most active peptidomimetics tested. They inhibited the inflammatory reaction up to 70-80%, when applied either immediately before sensitization or before challenge. POL-509, a methylated derivative of POL-257, inhibited the CHR to 40-50% when administered at either challenge or sensitization. However, when applied 24 h before the challenge, it completely abrogated the inflammatory reaction. The results show that these small molecular weight peptidomimetic compounds, as well as BB-94, are able to significantly inhibit the CHR. This finding opens possibilities for using metalloproteinase inhibitors in the treatment of allergic contact dermatitis and other inflammatory diseases.
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Affiliation(s)
- M Mattei
- Department of Biology, NSTA, II University of Rome, Tor Vergata, Italy.
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31
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Sternberg CN, Calabrò F, Pizzocaro G, Marini L, Schnetzer S, Sella A. Chemotherapy with an every-2-week regimen of gemcitabine and paclitaxel in patients with transitional cell carcinoma who have received prior cisplatin-based therapy. Cancer 2001; 92:2993-8. [PMID: 11753976 DOI: 10.1002/1097-0142(20011215)92:12<2993::aid-cncr10108>3.0.co;2-2] [Citation(s) in RCA: 160] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND An every-2-week regimen of gemcitabine and paclitaxel was adapted for patients with advanced transitional cell carcinoma (TCC) who had received prior cisplatin-based chemotherapy. METHODS Forty-one patients with advanced or metastatic TCC who had received prior cisplatin-based systemic chemotherapy were treated with an outpatient regimen of gemcitabine 2500-3000 mg/m(2) and paclitaxel 150 mg/m(2) every 2 weeks. RESULTS Forty of 41 patients had measurable disease. Response was observed in 24 patients (60%; 95% confidence interval [CI], 45-75%). Eleven (28%) achieved complete response, and 13 (33%) obtained partial response. Twenty of 25 patients (80%; 95% CI, 64-96%) who had been previously treated in the neoadjuvant or adjuvant setting responded versus 4 of 15 (27%; 95% CI, 5-49%) in patients who received prior methotrexate, vinblastine, doxorubicin, cisplatin (M-VAC) for metastatic disease. The median duration of survival for patients given gemcitabine and paclitaxel after failing neoadjuvant or adjuvant M-VAC was 12 months (range, 2-43+), as compared with only 8 months (range, 2-28) for patients who had been treated after failure of prior therapy for metastatic disease. For all patients, the median duration of response was 6.4 months (range, 2-43.3+ months), and the median survival was 14.4 months (range, 2-43+). Thirteen patients (32%) developed World Health Organization Grade 3-4 neutropenia, with febrile neutropenia in 3 (7%) patients. Granulocyte colony-stimulating factor was given to 10 (24%) patients. There was no Grade 3-4 anemia or thrombocytopenia. CONCLUSIONS The combination of gemcitabine and taxol in previously treated patients with recurrent TCC is highly effective and produces objective durable responses. This every-2-week schedule is a well tolerated outpatient regimen with minimal toxicity.
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Hillier AC, Zhang X, Maunder GH, Liu SY, Eberspacher TA, Metz MV, McDonald R, Domingos A, Marques N, Day VW, Sella A, Takats J. Synthesis and structural comparison of a series of divalent Ln(Tp(R,R)')2 (Ln = Sm, Eu, Yb) and trivalent Sm(Tp(Me2))2X (X = F, Cl, I, BPh4) complexes. Inorg Chem 2001; 40:5106-16. [PMID: 11559067 DOI: 10.1021/ic010325w] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Reaction of LnI2 (Ln = Sm, Yb) with two equivalents of NaTp(Me2) or reduction of Eu(Tp(Me2))2OTf gives good yields of the highly insoluble homoleptic Ln(II) complexes, Ln(Tp(Me2))2 (Ln = Sm (1a), Yb (2a), Eu (3a)). Use of the additionally 4-ethyl substituted Tp(Me2,4Et) ligand produces the analogous, but soluble Ln(Tp(Me2,4Et))2 (1-3b) complexes. Soluble compounds are also obtained with the Tp(Ph) and Tp(Tn) ligands (Tn = thienyl), Ln(Tp(Ph))2 (Ln = Sm, 1c; Yb, 2c) and Ln(Tp(Tn))2 (Ln = Sm, 1d; Yb, 2d). To provide benchmark parameters for structural comparison the series of Sm(Tp(Me2))2X complexes (X = F, 1e; Cl, 1f; Br, 1g; I, 1h; BPh4, 1j) were prepared either via oxidation of the Sm(Tp(Me2))2 or salt metathesis from SmX3 (X = Cl, Br, I). The solid-state structures of 1-3a, 1b, 1-2c and 1e, 1f, 1h, and 1j were determined by single-crystal X-ray diffraction. The homoleptic bis-Tp complexes are all six-coordinate with trigonal antiprismatic geometries, planes of the kappa(3)-Tp ligands are parallel to one another. In the series of Sm(Tp(Me2))2X complexes the structure changes from seven-coordinate molecular compounds, with intact Sm-X bonds, for X = F, Cl, to six-coordinate ionic structures [Sm(Tp(Me2))2]X (X = I, BPh4), suitable crystals of the bromide compound could not be obtained. The dependence of the structures on the size of X is understandable in terms of the interplay between the size of the cleft that the [Sm(Tp(Me2))2](+) fragment can make available and the donor ability of the anionic group toward the hard Sm(III) center.
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Affiliation(s)
- A C Hillier
- Christopher Ingold Laboratories, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, United Kingdom
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Lopes I, Hillier AC, Liu SY, Domingos A, Ascenso J, Galvão A, Sella A, Marques N. Solid-state structure and solution behavior of eight-coordinate Sm(III) poly(pyrazolyl)borate compounds. Inorg Chem 2001; 40:1116-25. [PMID: 11300807 DOI: 10.1021/ic001056x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
[Sm(Tp(Me2)(2)(kappa(2)-S(2)CNR(2))] compounds (R = Et (1), Me (2); Tp(Me2) = HB(3,5-Me2pz)(3)) have been isolated from reaction of (R(2)NC(S)S)(2) with 2 equiv of [Sm(Tp(Me2)(2)]. Reductive cleavage of 2,2'-dipyridyl disulfide or 2,2'-dipyridyl diselenide by [Sm(Tp(Me2)(2)] afforded good yields of [Sm(Tp(Me2)(2)(kappa(2)-Y)] compounds (Y = 2-SC(5)H(4)N (3), 2-SeC(5)H(4)N (4)). 4 is the first selenopyridine complex of an f-block element. Sm(Tp(Me2)(2)(2-OC(5)H(4)N) (5) has been synthesized by salt metathesis of [Sm(Tp(Me2)(2)Cl] with the sodium salt of the 2-hydroxypyridine. The solid-state structures of 1, 3, 4, and 5 were determined by single-crystal X-ray diffraction analysis and revealed that the compounds are all eight-coordinate with dodecahedral geometry. The samarium atoms are bound in tridentate fashion to two pyrazolylborate ligands and in bidentate fashion by the third ligand. The solution behavior of the compounds was studied by (1)H NMR techniques. (1)H-(1)H exchange spectroscopy experiments give evidence for two distinct dynamic regimes occurring in solution.
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Affiliation(s)
- I Lopes
- Departamento de Química, ITN, Estrada Nacional 10, P-2686, Sacavém Codex, Portugal
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Abstract
OBJECTIVE To evaluate the value of aspirating sperm from the vas and epididymis at orchiectomy in azoospermic patients. DESIGN Retrospective clinical study. SETTING Tertiary care academic hospital. PATIENT(S) Three patients with known azoospermia who presented with testicular masses suspected to be cancerous. INTERVENTION(S) At orchiectomy, immediately after ligation of the spermatic cord, the contents of the epididymis and vas deferens were extracted into preserving media. MAIN OUTCOME MEASURE(S) Fertility rate. RESULT(S) Sperm retrieval was successful in all three patients. The mean total sperm count was 2.3 x 10(6)/mL with 20% motility. Intracytoplasmic injection of sperm harvested by using this method was successful in two couples, one of which delivered a healthy infant. CONCLUSION(S) Sperm can be aspirated from the vas deferens and epididymis at orchiectomy for preservation. In azoospermic patients, this procedure may salvage enough sperm for successful use in micromanipulation techniques. It may be worthwhile to perform sperm aspiration during orchiectomy for testis cancer in any patient with known or suspected infertility.
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Affiliation(s)
- J Baniel
- Urology Section, Rabin Medical Center, Belinson Campus, Petach Tikva, 41900 Israel.
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De Mulder PH, Theodore C, Sella A, Koriakine O, Sternberg CN, Collette L, de Balincourt C. Phase II EORTC trial with 5-fluorouracil, cisplatin and interferon-alpha as second-line treatment of advanced transitional cell cancer of the urothelial tract. Ann Oncol 2000; 11:1391-4. [PMID: 11142477 DOI: 10.1023/a:1026589120989] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Based on the favorable results of the combination 5-fluorouracil (5-FU), cisplatin and interferon-alpha as second-line treatment in advanced metastatic transitional-cell carcinoma of the urothelial tract a confirmatory study was executed in a multicenter setting. PATIENTS AND METHODS In this open label phase II study 43 patients failing adequate previous chemotherapy were treated with IFN-alpha2b 5 MU/m2 subcutaneously for 5 consecutive days starting on day 1 and 22 simultaneous with 5-FU 500 mg/m2 daily as a continuous infusion. In between the same dose of IFN-alpha2b was given 3 times weekly with CDDP 25 mg/m2 on days 1, 8, 15 and 22. This cycle was repeated every six weeks. RESULTS In 40 eligible patients 5 PR were seen (12.5%; 95% confidence interval (95% CI): 4.1%-26.8%). The major toxicity was hematological. Two toxic deaths were seen due to gastrointestinal hemorrhage. CONCLUSIONS In view of these results this combination can not be recommended as second line treatment for metastatic transitional-cell carcinoma of the urothelial tract.
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Affiliation(s)
- P H De Mulder
- Department of Medical Oncology, University Hospital Nijmegen, The Netherlands.
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Sella A, Flex D, Konichezky M, Sulkes A, Baniel J. Combination chemotherapy following adrenal suppression in androgen- independent prostate cancer. Eur Urol 2000; 38:255-8. [PMID: 10940697 DOI: 10.1159/000020290] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Recent trials with modern chemotherapy have demonstrated activity in androgen-independent prostate cancer, but all focused on patients with progression following androgen suppression or antiandrogen withdrawal. Limited data are available on the activity of chemotherapy in androgen-independent, hormone-refractory (progressing following adrenal suppression) prostate cancer. We evaluated the activity of estramustine combined with vinblastine in this subset of androgen-independent prostate cancer. METHODS From January 1995 until April 1999, 19 patients with hormone-refractory prostate cancer received estramustine 140 mg p.o., three times daily along with weekly vinblastine 5 mg/m(2). RESULTS A decrease in prostate-specific antigen of 50% or more was noted in 12 patients (63.1%, 95% CI 38.3-83.7%). The median decrease in prostate-specific antigen was 71.2% (range 50.5-85.2%). None of the 7 patients with measurable soft-tissue disease showed an objective response. The median survival from onset of chemotherapy was 6 (range 1.4-27.7) months and from initiation of adrenal suppression 16.9 (range 3.8-40. 5) months. CONCLUSIONS The combination of estramustine and vinblastine is capable of inducing activity in androgen-independent prostate cancer progressing after adrenal suppression. In our small sample, the survival rate was low, and we obtained no response in soft-tissue sites. Future prospective trials are needed to determine the benefit of sequential versus simultaneous incorporation of adrenal suppression with chemotherapy in the management of androgen-independent prostate cancer.
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Affiliation(s)
- A Sella
- Department of Oncology, Rabin Medical Center, Beilinson Campus, Petah Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Abstract
OBJECTIVES To describe the clinical parameters of low PSA, progressive metastatic androgen-independent prostate cancer. METHODS From April 1995 to May 1999, we selected 18 patients with clinically progressive androgen-independent prostate cancer and low PSA (</=10 ng/ml). Patients received cisplatin-based therapy. Specimens from the primary tumor were reviewed and neuroendocrine differentiation was determined with chromogranin-A and neuron-specific enolase immunocytochemical staining. RESULTS The median initial PSA level was 1.6 ng/ml (0-9.5). Each patient demonstrated elevation of at least one of the following markers: carcinoembryonic antigen, CA 19-9, CA15-3 and CA 125 CA. Metastases involved bone in 11 patients (61.1%) - 5 (27.7%) blastic, 2 (11.1%) lytic, and 4 (22.2%) combined - liver in 10 patients (55.5%), lymph nodes in 8 (44.4%), and lung in 6 (33.3%); solitary sites as orbit, skin and spleen were noted as well. A prostatic pelvic mass was detected in 13 patients (72.2%). Of the 12 patients who consented to chemotherapy, 8 (66.6%) achieved an objective response (95% CI, 34. 8-90%), including 1 patient with complete response. Hematoxylin and eosin evaluation revealed two major groups: neuroendocrine tumors, either pure small cell cancer in 6 patients (37.5%) or combined small cell cancer and adenocarcinoma in 8 (50%), and predominant poorly differentiated prostate cancer in 2 (12.5%). Neuroendocrine immunoreactivity was detected in all the specimens. CONCLUSIONS Progressive androgen-independent prostate cancer with low serum PSA is characterized by visceral metastases, high proportion of lytic bone disease, sensitivity to cisplatin-based chemotherapy, and histological features of small cell or poorly differentiated prostate cancer. In this subgroup of patients, selection of the therapeutic approach can be based on clinical parameters. The rise of the serum markers may aid in the diagnosis and follow-up of these patients.
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Affiliation(s)
- A Sella
- Genitourinary Medical Oncology Unit and Department of Oncology, Rabin Medical Center, Beilinson Campus, Petah Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Yossepowitch O, Engelstein D, Konichezky M, Sella A, Livne PM, Baniel J. Bladder neck involvement at radical prostatectomy: positive margins or advanced T4 disease? Urology 2000; 56:448-52. [PMID: 10962313 DOI: 10.1016/s0090-4295(00)00676-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To assess the prognosis of patients with bladder neck (BN) involvement in radical prostatectomy specimens and compare it with patients with seminal vesicle invasion (SVI) presumed to have an inferior stage according to the TNM classification. METHODS Two hundred eighty-six case files of consecutive radical prostatectomies were reviewed. The records of patients with pathologic BN involvement (pT4a) or SVI (pT3c) were thoroughly analyzed and compared. The mean and median follow-up periods were 30.8 and 35.5 months (range 9 to 40), respectively, for the patients with Stage pT4a and 40.8 and 44.1 months (range 8 to 86), respectively, for the patients with Stage pT3c. Particular attention was paid to the preoperative clinical and pathologic evaluation, the pathologic analysis of the prostatectomy specimen, and the postoperative follow-up data. Progression was defined as a prostate-specific antigen level of 0.2 ng/mL and rising. Adjuvant therapy was not initiated unless prostate-specific antigen failure had occurred. RESULTS BN involvement was identified in 25 patients (8.7%) and SVI was found in 26 patients (9.1%). In 7 patients (2.4%), the BN was the only site of positive margins. Thirty-six percent of patients with BN involvement and 62% of patients with SVI demonstrated biochemical progression. Disease-free survival and metastasis-free survival rates were significantly better for the patients with Stage pT4a than for the patients with Stage pT3c at 24 and 36 months after surgery. Univariate analysis identified the prostate-specific antigen nadir to be the most significant predictor of prognosis. CONCLUSIONS In this study, BN involvement in the surgical specimen carried a lower risk of progression than SVI. On the basis of our preliminary results and those in other studies, a conceivable downstaging of BN involvement in the TNM staging system should be considered. Possibly, additional modification of the TNM staging system should be contemplated on the basis of the results of pathologic analysis and prognosis. The significance of BN involvement and the role of adjuvant therapy in this group of patients need further evaluation.
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Affiliation(s)
- O Yossepowitch
- Institute of Urology, Rabin Medical Center, Beilinson Campus, Petach-Tikva, Israel
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Hillier AC, Liu SY, Sella A, Elsegood MR. Lanthanide chalcogenolate complexes: synthesis and crystal structures of the isoleptic series [Sm(TpMe,Me)2ER] (E = O, S, Se, Te; TpMe,Me = tris-3,5-dimethylpyrazolylborate). Inorg Chem 2000; 39:2635-44. [PMID: 11197020 DOI: 10.1021/ic9914793] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A series of lanthanide complexes containing a chalcogenolate ligand supported by two TpMe,Me (tris-3,5-dimethylpyrazolylborate) groups has been prepared and crystallized and provides direct comparisons of bonding to hard and soft ligands at lanthanide centers. Reaction of [Sm(TpMe,Me)2Cl] with NaOR (R = Ph, Ph-Bu(t)) gives [Sm(TpMe,Me)2OR] (1a and 1b, respectively) in good yields. Reductive cleavage of dichalcogenides by samarium(II) was used to prepare the heavier congeners. Complexes of the type [Sm(TpMe,Me)2ER] for E = S, R = Ph (2a), E = S, R = Ph-4-Me (2b), E = S, R = CH2Ph (2c), E = Se, R = Ph (3a), E = Se, R = Ph-4-Bu(t) (3b), E = Se, R = CH2Ph (3c), and E = Te, R = Ph (4) have been prepared together with the corresponding complexes with TpMe,Me,4-Et as ancillary. The X-ray crystal structures of 1b, 2b, 3a, 3b, and 4 have been determined. The crystal of 1b (C40H57B2N12OSm.C7H8) was monoclinic, P2(1)/c, a = 10.6845(6) A, b = 18.5573(11) A, c = 24.4075(14) A, beta = 91.616(2) degrees, Z = 4. The crystal of 2b (C37H51B2N12SSm) was monoclinic, P2(1)/n, a = 15.0154(9) A, b = 13.1853(8) A, c = 21.1254(13) A, beta = 108.628(2) degrees, Z = 4. The crystal of 3a (C36H49B2N12SeSm.C7H8) was triclinic, P1, a = 10.7819(6) A, b = 19.3011(10) A, c = 23.0235(12) A, alpha = 79.443(2) degrees, beta = 77.428(2) degrees, gamma = 89.827(2) degrees, Z = 4. The crystal of 3b (C40H57B2N12SeSm) was triclinic, P1, a = 10.1801(6) A, b = 10.2622(6) A, c = 23.4367(14) A, alpha = 88.313(2) degrees, beta = 86.268(2) degrees, gamma = 62.503(2) degrees, Z = 2. The crystal of 4 (C36H49B2N12TeSm.C7H8) was monoclinic, P2(1)/c, a = 18.7440(10) A, b = 10.3892(6) A, c = 23.8351(13) A, beta = 94.854(2) degrees, Z = 4. The compounds form an isoleptic series of seven-coordinate complexes with terminal chalcogenolate ligands. Examination of 1b and other crystallographically characterized lanthanide alkoxides suggests that there is little correlation between bond angle and bond length. The structures of 3a and 3b, however, contain molecules in which one of the pyrazolylborate ligands undergoes a major distortion arising from twisting around a B-N bond so as to give an effectively eight-coordinate complex with pi-stacking of the phenyl group with one pyrazolyl ring. These distortions shed light on the fluxionality of these systems.
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Affiliation(s)
- A C Hillier
- Christopher Ingold Laboratories, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, U.K
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Umansky L, Dorevitch A, Sella A. [Alopecia due to Seroxat therapy]. Harefuah 2000; 138:547-9, 614. [PMID: 10883182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
There are 2 stages of alopecia, anagen and telogen effluvium, both of which may be associated with medication-related alopecia. We describe massive hair loss in a 51-year-old woman during treatment with Seroxat (paroxetine), which remitted after it was discontinued. Pathological mechanisms of drug-associated alopecia are complex and have yet to be fully elucidated.
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Affiliation(s)
- L Umansky
- Psychiatry Chronic Dept., Eitanim Mental Health Center, Jerusalem
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Umansky L, Sella A. [Psychogenic polydipsia leading to water intoxication]. Harefuah 2000; 138:9-12, 87. [PMID: 10868168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Psychogenic polydipsia and its frequent complication, water intoxication, are well-known to psychologists. There are biochemical and psychiatric theories of psychogenic polydipsia which often correlate with each other. A 48-year-old man with chronic paranoid schizophrenia developed symptoms of psychogenic polydipsia. This provoked disturbances in electrolyte balance, resulting in a rapid decrease in serum sodium concentration and eventual death. There is a paucity of information and little awareness of this problem in the professional literature.
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Affiliation(s)
- L Umansky
- Psychiatry Dept., Eitanim Mental Health Center
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Abstract
Retroperitoneal lymph node dissection (RPLND) is utilized in low-stage testis cancer as a primary diagnostic and therapeutic procedure. In the post-chemotherapy setting, it serves as an adjuvant procedure to resect residual tumor. Primary RPLND entails minimal resection of lymphatic tissue in the retroperitoneum; the complications are minor and insignificant. Wound infection is the main complication, affecting less than 5% of patients. Atelectasis and small bowel obstruction may occur in less than 2% of patients. In post-chemotherapy RPLND, the template and the surgical challenge are much larger. Extensive tumor size, difficult location, adherence to major vessels, and vital structures, together with inferior pre-operative status, are probably the main reasons for complications. The overall complication rate is 20% to 35% and mortality is 0.8% to 1%. Pulmonary insufficiency secondary to bleomycin-induced interstitial fibrosis is the cause of the most severe side effects and mortality in these operations. Chylous ascites may occur, especially where resection of the inferior vena cava is necessary. Other complications occur to a lesser extent. A summary of all complications is presented and measures to avoid or manage them are depicted.
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Affiliation(s)
- J Baniel
- Urology Section and Uroneurology, Rabin Medical Center, Beilinson Campus, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel.
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Marini L, Sternberg C, Sella A, Calabrò F, Van Rijn A. Gemcitabine and paclitaxel in previously treated patients with advanced transitional cell carcinoma. Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)81826-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sella A. [Information provided in writing for "informed consent" in clinical trials]. Harefuah 1999; 136:669-72, 756. [PMID: 10955084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The Helsinki Declaration contains recommendations guiding physicians who conduct clinical trials. One is that the requirement for informed consent is essential for approval of a trial. An important component of the informed consent doctrine is that all data required for the participant's decision must be provided. We analyze data of a therapeutic trial, and define 12 data components outlined in, or directly derived from the Helsinki Declaration. 61 instances of informed consent for therapeutic clinical trials from various fields of medicine, from 1994 to 1997, were analyzed. In each the presence of the 12 components was evaluated. The data demonstrated that there were only 5 components cited in most cases of informed consent: trial objectives, methods, treatment plan, risks, and the option of withdrawing. Benefit to the participant was mentioned in half the cases, while only limited information was provided about other components such as life-threatening and unpredictable risks, and alternative treatment. Examples of informed consent from 1997 showed statistical improvement since 1994 in the data concerning trial objectives, methods, risks and alternative therapy. Informed consent documents of international multicenter trials compared with local trials showed statistical improvement in the data components of the trial objectives, methods, and risks, including those of potentially life-threatening and unpredictable risks, and alternative therapy. Analysis of informed consent showed that not all components required for a comprehensive decision regarding participation in a clinical trial are included. These data emphasize the need to design a structured informed consent protocol in which all the required data components are specifically outlined for potential participants.
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Affiliation(s)
- A Sella
- Dept. of Oncology, Rabin Medical Center (Beilinson Campus), Petah Tikva
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Sella A, Flex D, Gafni D, Rabinovitz O, Sulkes A, Baniel J. [Combination chemotherapy with M-VAC protocol in metastatic urothelial cancer]. Harefuah 1999; 136:268-71, 340, 339. [PMID: 10914214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The treatment of metastatic urothelial cancer is based on the combination of cisplatin, methotrexate, vinblastine and adriamycin (M-VAC). From November 1994 to May 1997 we treated 25 patients (51 men, 3 women, aged 50-77) with M-VAC. The tumor originated from the urinary bladder in 14 (56%) and the upper urinary tract in 11 (44%). Disease sites included: primary--5 (25%), lymph nodes--17 (68%), lungs--10 (40%), bones--8 (32%), pelvic mass and liver each--4 (16%), with an overall median of 2 (1-5) sites per patient. 9 patients (38%) had complete responses and 8 (32%) had partial responses, for an overall response rate of 68% (95% CI 48.5%-85%). The median duration of response was 15.3 (1.6-29.6+) months. Median survival of responders was 19.1 (4.8-35.7+) months compared to 6.2 (0.7-11.2) for the non-responders (p < 0.05). 13 (52%) of patients are alive, of whom 8 (32%) are free of disease and 5 with a single metastatic site on presentation at follow-up. In the 118 treatment cycles we observed grade III-IV toxicity: myelosuppression 53 (45%), thrombocytopenia 4 (3%), stomatitis 8 (6.7%), diarrhea 3 (2.5%). There were 22 infectious episodes and 1 patient died of sepsis. We achieved a high response rate with the combination M-VAC. However, only a third had long-term disease-free states and treatment was associated with excessive toxicity. Therapeutic approaches with new agents are required to improve the response rate and toxicity.
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Affiliation(s)
- A Sella
- Dept. of Oncology, Rabin Medical Center, Petah Tikva
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D'Alessio S, Gallina C, Gavuzzo E, Giordano C, Gorini B, Mazza F, Paradisi MP, Panini G, Pochetti G, Sella A. Inhibition of adamalysin II and MMPs by phosphonate analogues of snake venom peptides. Bioorg Med Chem 1999; 7:389-94. [PMID: 10218833 DOI: 10.1016/s0968-0896(98)00243-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Phosphonate analogues of the peptidomimetic N-(Furan-2-yl)carbonyl-Leu-Trp-OH were prepared with the goal of evaluating the effect of phosphonate for carboxylate replacement on binding with snake venom metalloproteinases and MMPs. N-(Furan-2-yl)carbonyl-Leu-L-Trp(P)-(OH)2 showed a 75-fold increase of the inhibiting activity against adamalysin II, a snake venom metalloproteinase structurally related to MMPs and TACE. Both the phosphonate and carboxylate peptidomimetics fit into the active site adopting a retrobinding mode and provide the structural base for a new class of metalloproteinases inhibitors.
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Abstract
OBJECTIVES To determine whether the antiandrogen withdrawal syndrome occurs with the steroidal antiandrogen cyproterone acetate. METHODS Cyproterone acetate was withheld in 12 patients with progressing androgen-independent metastatic prostate cancer. Eight patients had been receiving cyproterone acetate concomitant with androgen ablation, and in 4 patients it was prescribed after failure of androgen suppression. Time to response and to disease progression were defined by serum prostate-specific antigen (PSA) levels and imaging studies. RESULTS PSA levels decreased in 5 of the 1 2 patients; in 4 of them (33%), the decrease exceeded 50%. The decline lasted a median of 24 weeks (range 9 to 37.8). All 5 patients had received initial concomitant exposure to androgen ablation and cyproterone acetate. CONCLUSIONS We recommend that the steroidal antiandrogen cyproterone acetate be added to the list of agents capable of inducing antiandrogen withdrawal syndrome.
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Affiliation(s)
- A Sella
- Genitourinary Medical Oncology Unit, Rabin Medical Center, Petah Tikva, Israel
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Corral DA, Sella A, Pettaway CA, Amato RJ, Jones DM, Ellerhorst J. Combination chemotherapy for metastatic or locally advanced genitourinary squamous cell carcinoma: a phase II study of methotrexate, cisplatin and bleomycin. J Urol 1998; 160:1770-4. [PMID: 9783949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
PURPOSE The prognosis of patients with advanced squamous cell carcinoma of genitourinary origin is poor. While single agent chemotherapy results mainly in partial responses of short duration, data on the efficacy of combination chemotherapy are extremely limited. We determined the response rate and toxicity of a combination of 3 of the most active agents, methotrexate, cisplatin and bleomycin, in patients with advanced genitourinary squamous cell carcinoma. MATERIALS AND METHODS Patients with metastatic or locally advanced genitourinary squamous cell carcinoma were eligible for study. Treatment consisted of 200 mg./m.2 methotrexate on days 1, 15 and 22, and 20 mg./m.2 cisplatin and 10 mg./m.2 bleomycin on days 2 through 6 during a 28-day cycle. RESULTS Of the 30 patients who enrolled in the trial 29 were evaluable for response. Objective response was achieved in 16 patients (55%, 95% confidence interval 36 to 72), 4 of whom achieved a complete response (14%). Median objective response duration was 4.7 months (range 1.9 to 39.5). Median survival of the entire group was 11.5 months (range 1.5 to 87.0). Of the patients 9 achieved disease-free status, including 6 following consolidation surgery or radiation therapy. Median survival of these 9 patients (34.4 months, range 9.6 to 87.0) was significantly greater (p = 0.0003) than that of patients who did not become disease-free (7.0 months, range 1.5 to 38.6). Grade III or IV hematological toxicity in 116 courses included neutropenia (13%) and thrombocytopenia (6%). Among 30 patients evaluable for toxicity serious nonhematological toxic effects included stomatitis (3%) and renal toxicity (7%). There was 1 death from neutropenic sepsis. CONCLUSIONS Methotrexate, cisplatin and bleomycin combination chemotherapy for genitourinary squamous cell carcinoma results in a high but short lived overall response rate, and a low complete response rate with manageable toxicity. A multidisciplinary approach to achieve disease-free status may provide the best opportunity to effect survival and should be the focus of future trials.
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Affiliation(s)
- D A Corral
- Department of Urology, University of Texas M.D. Anderson Cancer Center, Houston, USA
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Abstract
OBJECTIVES To retrospectively analyze intravesical bacillus Calmette-Guerin (BCG) treatment for Stage T1 grade 3 (T1G3) transitional cell carcinoma (TCC) of the bladder. METHODS Between 1984 and 1995, 78 patients with Stage T1 grade 3 tumor were treated by transurethral resection of all visible tumors and adjuvant BCG intravesical instillations. Median follow-up was 56 months (range 12 to 141). RESULTS After an initial induction course, 52 patients (67%) were tumor-free. Twenty-two patients (28%) had recurrent tumor after a median of 7 months (range 5 to 62). Progression occurred in 6 patients (7.7%) after a median of 18 months (range 5 to 56). CONCLUSIONS Intravesical BCG appears to be an effective treatment for patients with Stage T1 grade 3 TCC. Patients whose tumors recur after an initial induction course may benefit from a second course of BCG. Intravesical BCG treatment may lower the tumor progression rate. Late recurrence, beyond 2 years, warrants long-term follow-up.
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Affiliation(s)
- J Baniel
- Department of Urology and Oncology Institute, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel
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Ellerhorst JA, Sella A, Amato RJ, Tu SM, Millikan RE, Finn LD, Banks M, Logothetis CJ. Phase II trial of 5-fluorouracil, interferon-alpha and continuous infusion interleukin-2 for patients with metastatic renal cell carcinoma. Cancer 1997; 80:2128-32. [PMID: 9392335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND This study was designed to evaluate the efficacy and toxicity of the combination of 5-fluorouracil, interferon-alpha, and interleukin-2 for patients with metastatic renal cell carcinoma. METHODS Previously untreated patients with a Zubrod performance status of < or =2; adequate cardiac, pulmonary, and renal function; and absence of brain metastases were eligible. One course of therapy was 28 days. 5-fluorouracil was administered at a dose of 600 mg/m2/day as a continuous infusions on Days 1-5. Interleukin-2 also was administered as a continuous infusion on Days 1-5 at a dose of 2 million Roche U/m2/day. Interferon-alpha was given as a daily subcutaneous injection of 4 million U/m2/day. RESULTS Fifty-five patients were enrolled in the trial and 52 were evaluable for response. All patients experienced fever and flu-like symptoms. Grade 3 or 4 nonhematologic toxic effects included hypertension (48%), dermatitis (12%), stomatitis (11%), and altered mental status (9%). There was one toxic death. Four complete responses and 12 partial responses were observed for a total response rate of 31% (95% confidence interval, 18-46%). The survival of responding patients was significantly better than that of nonresponding patients. The improvement in survival was even more significant when comparing patients with at least stable disease with those who progressed through treatment. CONCLUSIONS The three-drug combination described in this study demonstrates activity. However, it appears to be more toxic than other regimens with similar response rates and cannot be recommended for standard practice. Changing the interleukin-2 route to subcutaneous administration may permit more continuous administration with less toxic effects.
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Affiliation(s)
- J A Ellerhorst
- Department of Genitourinary Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA
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