Two patients with advanced adenocarcinoma of the fallopian tube were treated with cis-diamminedichloroplatinum, adriamycin, and progestins. Cyclophosphamide was added to the treatment of 1 patient. Both regimens achieved surgically proved complete remission. No severe drug-related toxicity occurred.
The effects of gentamicin, tetracycline, and a combination of neomycin and sulfathiazole on bone marrow proliferation were studied in mice. Spleen colony and granulocyte production by syngeneic bone marrow transplanted to lethally irradiated mice were significantly decreased when antibiotics were administered to the marrow recipients. Antibiotic administration to marrow donors had no effect on marrow proliferation before or after transplantation. It is likely that the observed effects were the result of alterations in the gastrointestinal flora of the marrow transplant recipients.
Abstract The BATLE LE TCA‐100 tumour chemosensitivity assay has been used to evaluate chemotherapeutic drug sensitivity of cultured tumour cell lines. Studies were performed using test drug concentrations calibrated to discriminate sensitivity and resistance of clinical specimens. Strong sensitivity which appeared to be inconsistent with clinical experience was detected for some drugs and cell lines. Findings of strong sensitivity were consistent with basic differences between sensitivity testing cultured cell lines and clinical specimens. Results with cell lines frequently may not apply directly to clinical applications. Characterization of differences between cell lines and clinical specimens may assist in application of cell line findings to clinical trials.
e14546 Background: Multidrug chemotherapy improves rates and quality of response in cholangiocarcinoma.It also delays progression and appears to improve survival for the, unresectable and recurrent, high-risk patients (ICACT Bruckner, H et al Paris 2004). This is analogous to experience with treatment for pancreatic cancer (Bruckner, H. et. al ASCO 2008). Methods: Chemotherapy with gemcitabine, 5-flourouracil, irinotecan, leucovorin, oxaliplatin (GFLIOx) and GFLIOx+ docetaxel, mitomycin-C (GFLIO-TXT±MMC) was used sequentially for 50 patients in order to produce opportunities for resection, debulking surgery, TACE and Yittrium 90. Analysis excluded ideal patients with either less than 5cm or well differentiated primary tumors. Prior oversight, safety, eligibility and consent procedures were employed in these ongoing retrospective analysis. Results: GFLIOx produced a 50% rate of benefit for six months or more and 19.5 months median overall survival. In sequence, on progression addition of both TXT and MMC produced a 90% rate of benefit, all for 6 months or more in duration and a median survival of 10 months from time of first addition. Chemotherapy sometimes eradicated bulky lymph node disease of bile duct and gallbladder origin and produced opportunities for multi-modality care. There were no hospitalizations for febrile nutropenia or bleeding due to thrombocytopenia. Treatment was well tolerated up to age 80 years. Final review of additional patients, patient characteristics, and impact on surgery will be available in April 2011. Conclusions: These findings satisfy our criteria for continued use, including median survival greater than one year and high quality, sometimes rapid, second-line responses. Findings also support testing these low dose combinations in both neoadjuvant and classic adjuvant settings. It is feasible to produce multidisciplinary opportunities and multi-year, treatment-free survivors with "palliative" low dose treatments for recurrent and unresectable disease. Secondary benefits include reduced cost and adverse events, compared to high dose standard therapy.
A 60-year-old female presented with a one-year history of multiple enlarging tender subcutaneous nodules. Initial biopsy demonstrated a poorly differentiated adenocarcinoma. Mammography showed multiple nodular breast lesions. After the patient failed to respond to tamoxifen, a second biopsy demonstrated a metastatic carcinoid tumor. Further search revealed a single small pulmonary nodule, which on aspiration biopsy proved to be a carcinoid tumor. The patient failed to respond to treatment with streptozotocin and 5'-fluorouracil. Therapy with leucovorin calcium and 5'-fluorouracil then produced a partial response.
Despite progress in treating many solid tumors, pancreatic cancer continues to be a grave illness. Each year, >29,000 new cases of adenocarcinoma of the pancreas are diagnosed in the United States. Of these patients, only 10–20% have resectable tumors and 25,000 patients (83%) die within 12 months of diagnosis. Until recently, surgery has been the only "effective" therapy available for select patients. Historically, the operative mortality after radical pancreatic resection has been variable, ranging 1–30%, and is both operator-and institution-dependent. Even with a safe and complete surgical resection, the actual 5-year survival after surgery alone is essentially zero, although rates up to 5% have been reported. Despite what would appear to be a dismal outlook, slow progress has occurred in the operative and postoperative care of patients with pancreatic cancer. Advanced imaging techniques and laparoscopy have limited the number of unnecessary laparotomies, and novel adjuvant and neoadjuvant chemotherapy approaches have yielded promising results. This review will summarize the recent literature concerning the surgical therapy and trends in the treatment of carcinoma of the pancreas from 1990 to 1999.
