Combination chemotherapy of advanced breast cancer: comparison of dibromodulcitol, doxorubicin, vincristine, and fluoxymesterone to thiotepa, doxorubicin, vinblastine, and fluoxymesterone: an Eastern Cooperative Oncology Group Study
Article Abstract:
Patients who are treated with a second round of chemotherapy after failure of a first round tend to have poorer responses which are of shorter duration. It would be important to have a second round of effective chemotherapy to which tumors would not be cross-resistant (i.e. a resistance provoked by the first round of chemotherapy which is applicable to drugs in the second). Based on favorable responses to thiotepa, dibromodulcitol, and fluoxymesterone (Halotestin), combinations of these agents with doxorubicin (Adriamycin) have been tried in women with recurrent, residual, or metastatic breast cancer. Complete or partial responses were achieved by 32 percent of patients treated with DAVH (dibromodulcitol, Adriamycin, vincristine, and Halotestin), and by 38 percent of patients treated with TAVH (thiotepa, Adriamycin, vincristine, and Halotestin). Including improvement in bone metastatic disease, the overall rate of response was 40 percent. The largest difference between the two treatment protocols was the response to therapy by patients who had failed previous treatment; they responded as well to TAVH as did patients with successful previous treatment, but not to DAVH. Although responses to the two protocols were not significantly different, the trends in duration of response (8 months), time to treatment failure, survival (13 to 15 months), and toxicity all favored TAVH treatment. Side effects included an increase in infection rate, toxicity affecting nerves, as well as nausea and vomiting. Five of the DAVH and two of the TAVH patients died as a result of treatment with these regimens. The study indicates that TAVH and DAVH chemotherapy protocols are good candidates for treatment of resistant breast cancer; further study is needed. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1989
User Contributions:
Comment about this article or add new information about this topic:
Combination hormonal therapy with tamoxifen plus fluoxymesterone versus tamoxifen alone in postmenopausal women with metastatic breast cancer: an updated analysis
Article Abstract:
Postmenopausal women with breast cancer often benefit from the inclusion of an anti-estrogen agent in their treatment program. The drug tamoxifen has long been considered to be the hormonal agent of choice, but some preliminary results have indicated that the drug fluoxymesterone may provide some advantages. In a previous study, tamoxifen plus fluoxymesterone was demonstrated to provide some advantage over tamoxifen alone, but the advantage was not considered large enough to warrant recommending the inclusion of fluoxymesterone in the standard treatment protocol. Further research has now shown that the combination of drugs may be particularly useful in the treatment of postmenopausal women with higher levels of estrogen receptors on their cancer cells. A total of 238 women with metastatic breast cancer were treated with tamoxifen alone or in combination with fluoxymesterone. Forty-two percent of the tamoxifen-only patients achieved an objective response while 54 percent of the patients receiving the combination treatment did so, a difference which was not quite statistically significant. Twenty-three percent of the tamoxifen group and 17 percent of the combination group achieved disease-free survival for more than five years. Some of the patients, but not all, were tested for the levels of estrogen receptors. The majority of these patients were found to have estrogen receptor concentrations on their cancer cells greater than 10 femtomoles per milligram (a femtomole is one quadrillionth of a mole, about 600 million molecules). When only these patients were compared in a post hoc statistical analysis, patients treated with the combination of tamoxifen and fluoxymesterone had what the authors call a substantial survival advantage. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
Continuous cyclophosphamide, doxorubicin, vincristine, and prednisolone: a new, innovative protocol for diffuse aggressive lymphomas
Article Abstract:
Non-Hodgkin's lymphomas are a heterogeneous class of cancers, each of which has a different clinical picture. Although the diffuse large lymphomas have a good prognosis, with complete remission rates between 80 and 95 percent and long-term disease-free survival between 70 and 75 percent, some histologic groups continue to present challenges to chemotherapy. In this study, a new chemotherapeutic protocol was evaluated for the 'diffuse aggressive lymphomas', a class including diffuse mixed lymphoma, diffuse lymphocytic poorly differentiated lymphoma, lymphocytic-histiocytic lymphoma, and diffuse histiocytic, diffuse undifferentiated, and lymphoblastic lymphomas. The treatment consisted of eight weeks of chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone, which was called the continuous-CHOP treatment. The clinical chemotherapy trial included 108 patients with high and intermediate grade tumors. A complete response rate of 78 percent was achieved; this result is comparable with other modern protocols, and an improvement over the original CHOP protocol. Of those achieving a complete response, 79 percent were relapse-free at three years; 57 percent of all patients were relapse-free after three years. This figure cannot yet be considered a cure rate. Although the long-term survival rates among the so-called diffuse aggressive lymphomas are comparable, the diffuse poorly differentiated lymphomas can relapse up to five years after the end of treatment. Despite the on-going need for improvement, the continuous-CHOP protocol is effective and has the advantage of combining several diagnostic categories into a single therapeutic group. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: Combination chemotherapy and high-dose cyclophosphamide intensification for poor prognosis breast cancer: a Southwest Oncology Group Study
- Abstracts: Detection of breast cancer. Factors to be considered in organizing systems for breast cancer detection. The Health Insurance Plan of New York Study: clinical aspects
- Abstracts: Motivating women to participate in breast cancer detection. Detecting early breast cancer: experience in a community hospital
- Abstracts: A plea for sensible management of myocardial contusion. A unified approach to the torn thoracic aorta. Validating the selective management of penetrating neck wounds
- Abstracts: Extracorporeal membrane oxygenation for hydrocarbon aspiration. Changing spectrum of cholelithiasis and cholecystitis in infants and children