To investigate the presumption that earlier diagnosis of ovarian tumors might lead to an improved outcome, we compared several substances in the fluid of benign and malignant ovarian cysts. Our results showed the following: (1) benign cysts were readily separated from malignant cysts on the basis of total lactate dehydrogenase (LD) activity and except for mucinous cysts, by their isoenzyme patterns. (2) Preoperative serum total LD activity and LD isoenzymes were of no diagnostic help in predicting the malignant tumors. (3) Carcinoembryonic antigen (CEA) levels usually differed greatly between benign and malignant cysts, although the benign mucinous cysts had CEA levels indistinguishable from malignant cysts. (4) Prominent quantitative differences between Roche and Abbott CEA activity were present in both benign and malignant cysts. (5) Preoperative serum CEA levels were not helpful in differentiating the benign from the malignant cysts.
One hundred eighty six patients of non-small cell lung cancer treated with cisplatin-based chemotherapy were analyzed. Significant incidence of anemia was observed in PS 2-3 patients as compared to PS 0-1 cases. Incidence of thrombocytopenia was significant in cases 70 or more years old as compared those less than 50 years old. No correlation was detected between myelotoxicity and aging.
The ofloxacin (OFLX) concentration in serum, saliva and pleural effusion was measured in 12 patients with pleural effusion after oral administration at a dose of 200 mg three times a day (600 mg daily). Three patients had non-small cell lung cancer and the others had pulmonary tuberculosis. The mean OFLX levels in the serum, saliva and pleural effusion at 2 hours after the first administration on day 3 was 3.15 +/- 1.52, 3.36 +/- 2.23 and 2.86 +/- 1.77 micrograms/ml respectively. There was a strong correlation among these concentrations. The OFLX concentration of pleural effusion was predictable from that of saliva. A 3-day oral administration is sufficient to achieve the OFLX level of pleural effusion similar to that of the serum. It is possible that OFLX is effective for pleuritis caused not only by common infectious pathogens but also by Mycobacterium tuberculosis.
A 62-year-old woman was diagnosed with stage IV lung adenocarcinoma. After resection of a metastatic brain tumor, she had received first-line chemotherapy consisting of 6 courses of carboplatin and pemetrexed, then 14 courses of maintenance therapy of pemetrexed until disease progression. As second-line treatment, she was administered nanoparticle albuminbound paclitaxel(nab-paclitaxel)monotherapy. A nearly complete response(nearly CR)has been maintained for 3 years without any severe adverse events. Although there is insufficient evidence for the use of nab-paclitaxel monotherapy as second-line chemotherapy, it could be an effective treatment option for patients with recurrent advanced non-small cell lung cancer.
ATP-binding cassette, sub-family C, number 2 (ABCC2) is involved in the biliary excretion of irinotecan and its metabolites, SN-38 and SN-38 glucuronide. Effects of the ABCC2 genotype on the pharmacokinetics (PK) of irinotecan and the metabolites were examined in Japanese patients with metastatic colorectal cancer receiving irinotecan plus infusional 5-fluorouracil/leucovorin (FOLFIRI). ABCC2 genotypes (−1549G>A, −1023G>A, −1019A>G, −24C>T, 1249G>A and 3972C>T) and haplotypes were analyzed for 67 patients with cancer. PK was also examined in a subset of 31 patients receiving FOLFIRI. Relationship between the ABCC2 genotypes or diplotypes and area under the time–concentration curve (AUC) of irinotecan and the metabolites normalized by irinotecan dose was analyzed. The lower AUC of irinotecan was seen in patients with A/A or G/A genotypes at 1249 of the ABCC2 gene than others (p=0.011, Mann–Whitney U teat). AUC of SN-38 in patients with A/A or G/A genotypes at −1023 was significantly lower than that in others (p=0.018). The haplotype I included −1023A (GAACGC) was the most frequent one with the allele frequency of 0.366. The AUC of SN-38 observed in patients with diplotypes harboring at least one haplotype I was lower than that observed in others (p=0.023). The haplotype IV consisted of 1249 (GGACAC) and was the fourth most frequent one with the allele frequency of 0.127. Patients with diplotypes carrying at least one haplotype IV showed lower AUC of irinotecan than others (p=0.011). Thus, ABCC2 genotype is one of the predictors of the variability of irinotecan PK in Japanese patients with metastatic colorectal cancer receiving FOLFIRI.
e17544 Background: Seeking a second opinion has become relatively common among patients with life-threatening diseases in Japan. We investigated the backgrounds and situations of patients with inoperable cancer who sought a second opinion. Methods: We analyzed medical referral letters provided by physicians or surgeons in charge and medical information from patients and their families who visited Saitama University Hospital and Saitama International Medical Center between December 2003 and January 2012. Results: 360 patients and/or their families visited the Department of Medical Oncology. We excluded 29 patients from analysis because of insufficient medical information, unconfirmed malignancy, or early-stage cancer. 99 patients and 49 patients were referred by designated cancer hospitals and university hospitals, respectively. Only family members visited for 107 patients (32%). 248 patients (75%) had previously received chemotherapy (1-10 regimens). Surgeons/surgical oncologists managed most cases, except for lung cancer. Poor general condition (PS 3-4) was reported in 83 patients (25%). Treatment options were not proposed in 97 patients (29%), and only 4 patients (1.2%) were recommended to participate in clinical trials by their doctors. Conclusions: Patients are strongly recommended to seek a second opinion while in good general condition, before receiving aggressive treatment. All doctors who are treating cancer patients must be informed about clinical trials, including accessibility.
