High-dose intensity systemic therapy of metastatic bladder cancer.

1987 ◽  
Vol 5 (3) ◽  
pp. 450-455 ◽  
Author(s):  
W J Hrushesky ◽  
R V Roemeling ◽  
P A Wood ◽  
T R Langevin ◽  
P Lange ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Combination Chemotherapy ◽  
Systemic Therapy ◽  
Metastatic Cancer ◽  
Transitional Cell ◽  
Dose Intensity ◽  
High Dose ◽  
Complete Disappearance ◽  
Carcinoma Of The Bladder ◽  
High Dose Intensity

Forty-three consecutively diagnosed patients with widely metastatic transitional cell carcinoma of the bladder (TCCB) were treated with a high-dose intensity, chronobiologically timed combination of doxorubicin and cisplatin, followed by Cytoxan (Mead Johnson Pharmaceuticals, Evansville, IN), 5-fluorouracil (5-FU), and cisplatin maintenance for up to 2 years. Fifty-seven percent of the 35 evaluable patients with widespread metastatic cancer responded objectively. Twenty-three percent had complete disappearance of all cancer. Median survival from first treatment for complete responders (CRs) was more than 2 years, and 1 year for partial responders (PRs). Three of the CRs were alive without evidence of cancer more than 2 years after stopping all therapy. High-dose intensity combination chemotherapy can induce durable CRs of widespread bladder cancer.

High-dose-intensity combination chemotherapy for advanced sarcomas: a pilot study

1998 ◽  
Vol 41 (6) ◽  
pp. 513-516
Author(s):  
Paolo Pronzato ◽  
Pierluigi Losardo ◽  
Floriana Pensa ◽  
Alessandra Tognoni
Keyword(s):  
Pilot Study ◽  
Combination Chemotherapy ◽  
Dose Intensity ◽  
High Dose ◽  
High Dose Intensity

scholarly journals High dose intensity combination chemotherapy for advanced epithelial ovarian carcinoma: results of a pilot study

1990 ◽  
Vol 61 (2) ◽  
pp. 319-322 ◽  
Author(s):  
JW Sweetenham ◽  
JJ McKendrick ◽  
DH Jones ◽  
JMA Whitehouse ◽  
CJ Williams
Keyword(s):  
Pilot Study ◽  
Ovarian Carcinoma ◽  
Combination Chemotherapy ◽  
Dose Intensity ◽  
Epithelial Ovarian Carcinoma ◽  
High Dose ◽  
High Dose Intensity

Early outcomes with neoadjuvant high-dose intensity methotrexate, vinblastine, doxorubicin, and cisplatin (HD-MVAC) or gemcitabine and cisplatin (GC) in muscle-invasive urothelial carcinoma of the bladder: A single-institution experience.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 280-280 ◽  
Author(s):  
N. Mitra ◽  
J. P. Monk ◽  
K. S. Pohar ◽  
A. Shabsigh ◽  
D. S. Sharp ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Dose Intensity ◽  
Complete Response ◽  
Invasive Bladder Cancer ◽  
High Dose ◽  
Muscle Invasive Bladder Cancer ◽  
Carcinoma Of The Bladder ◽  
Muscle Invasive ◽  
Median Interval

280 Background: Compared to MVAC, HD-MVAC achieves significantly higher complete response rates in patients (pts) with metastatic bladder cancer. Based on current literature, 7%-38% of pts with muscle-invasive bladder cancer achieve pathological down-staging (pT0) with neoadjuvant chemotherapy (NC), which correlates with improved disease-free and overall survival. The role of HD-MVAC has not been evaluated in the neoadjuvant setting. In this retrospective study, we present our data in pts who received NC with HD-MVAC or GC followed by radical cystectomy (RC). Methods: From July 2008 to August 2010, 38 (pts) received 4 cycles of NC with either HD-MVAC or GC for at least T2 bladder cancer followed by RC. The endpoints of interest of this study were the complete pathologic response (pT0) or down-staging to < pT2 (pT0, pTis, and pT1) at RC; and median interval to RC from the time of diagnosis of muscle-invasive bladder cancer and start of NC. Results: Median age at the time of diagnosis was 66 years (35-80 years). Fifteen pts received neoadjuvant HD-MVAC, and 23 received neoadjuvant GC. Clinical T stage at the time of diagnosis was T2 in 29 (76%), T3 in 3 (8%), and T4 in 6 (16%) pts. Down-staging to < pT2 was achieved in 8 (53%) of HD-MVAC pts and 10 (43%) of GC pts. pT0 was achieved in 5 (33%) of HD-MVAC pts and 9 (39%) of GC pts. The median interval from time of diagnosis to RC was 129 days (range 84-154) for the HD-MVAC pts, and 145 days (range 108-252) for the GC pts. The median interval from initiation of NC to RC was 85 days (range 53-122) for the HD-MVAC pts and 107 days (range 60-126) for the GC pts. Overall, NC was well tolerated with 80% of HD-MVAC pts and 78% of GC pts completing the planned chemotherapy. To this date, none of the pT0 pts had recurrence. Conclusions: Both neoadjuvant HD-MVAC and GC appear to be well tolerated, with very promising rate of pathological down-staging. Longer follow-up is needed for the survival outcomes of these patients. A shorter interval from diagnosis and initiation of NC to RC might be responsible for our better outcomes comparing to some historical data. No significant financial relationships to disclose.

Systemic Therapy for Osteosarcoma and Ewing Sarcoma

2015 ◽  
pp. e644-e647 ◽  
Author(s):  
Paul A. Meyers
Keyword(s):  
Ewing Sarcoma ◽  
Systemic Therapy ◽  
Dose Intensity ◽  
Initial Response ◽  
Response To Therapy ◽  
High Dose ◽  
Improve Outcome ◽  
Curative Therapy ◽  
Dose Methotrexate ◽  
Multiagent Chemotherapy

Curative therapy for both osteosarcoma and Ewing sarcoma requires the combination of effective systemic therapy and local control of all macroscopic tumors. Systemic therapy for osteosarcoma consists of multiagent chemotherapy. The most common regimen uses cisplatin, doxorubicin, and high-dose methotrexate. Addition of ifosfamide and etoposide to treatment for patients with poor initial response to therapy does not improve outcome. Addition of interferon to treatment for patients with favorable initial response does not improve outcome. Addition of liposomal muramyl tripeptide to chemotherapy may improve overall survival. Systemic therapy for Ewing sarcoma consists of multiagent chemotherapy including doxorubicin, vincristine, etoposide, and cyclophosphamide and/or ifosfamide. Increased dose intensity of therapy, either by shortening the intervals between cycles of chemotherapy or by increasing doses of chemotherapy, improves outcome. Regimens such as irinotecan/temozolomide or cyclophosphamide/topotecan have shown activity in metastatic recurrent Ewing sarcoma. Trials are ongoing to evaluate the addition of these drugs to existing multiagent regimens in order to test their ability to improve outcome. High-dose systemic therapy with autologous stem cell reconstitution is being tested for patients at high risk for recurrence; definitive results await completion of a prospective randomized trial.

scholarly journals Current Concepts in Biomarker Technology for Bladder Cancers

2000 ◽  
Vol 46 (5) ◽  
pp. 595-605 ◽  
Author(s):  
Martin Burchardt ◽  
Tatjana Burchardt ◽  
Ahmad Shabsigh ◽  
Alexandre De La Taille ◽  
Mitchell C Benson ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Matrix Protein ◽  
Transitional Cell ◽  
High Sensitivity ◽  
Diagnostic Techniques ◽  
Single Marker ◽  
Cell Cycle Regulatory Proteins ◽  
Standard Of Practice ◽  
Carcinoma Of The Bladder ◽  
Potential Biomarkers

Abstract Background: Transitional cell carcinoma of the bladder (TCC) is the second most common malignancy of the urinary tract. More than 70% of treated tumors recur, and 30% of recurrent tumors progress. Currently, pathologic staging and grading are valuable prognostic factors for detecting and monitoring TCC. Urinalysis, cystoscopy, and cytology are either invasive or lack sensitivity and specificity. The availability of a noninvasive, reliable, and simple test would greatly improve the detection and monitoring of patients with TCC. Several biomarkers for bladder cancer have been proposed, but no single marker has emerged as the test of choice. Approach: We undertook a comprehensive literature search using Medline to identify all publications from 1980 to 1999. Articles that discussed potential biomarkers for TCC were screened. Only compounds that demonstrated high sensitivity or specificity, significant correlation with TCC diagnosis and staging, and extensive investigation were included in this review. Content: Potential biomarkers of disease progression and prognosis include nuclear matrix protein, fibrin/fibrinogen product, bladder tumor antigen, blood group-related antigens, tumor-associated antigens, proliferating antigens, oncogenes, growth factors, cell adhesion molecules, and cell cycle regulatory proteins. The properties of the biomarkers and the methods for detecting or quantifying them are presented. Their sensitivities and specificities for detecting and monitoring disease were 54–100% and 61–97%, respectively, compared with 20–40% and 90% for urinalysis and cytology. Summary: Although urine cytology and cystoscopy are still the standard of practice, many candidate biomarkers for TCC are emerging and being adopted into clinical practice. Further research and better understanding of the biology of bladder cancer, improved diagnostic techniques, and standardized interpretation are essential steps to develop reliable biomarkers. It is possible that using the current biomarkers as an adjuvant modality will improve our ability to diagnose and monitor bladder cancer.

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