Cancer carcinoma, leukemia, tumor

Glucocorticoids have inhibitory (apoptotic) effects on lymphocyte proliferation and are used to treat leukemias and lymphomas. Estrogens (fosfestrol) are used to block the effect of androgens in prostate cancer. Progestogens (megestrol, medroxyprogesteroneacetate) have been useful for treating endometrial carcinoma, renal tumors, and breast cancer. 

Cancer chemotherapy is only one method of treating neoplastic disease. The other primary weapons in the anticancer arsenal are surgery and radiation treatment.18,61 The choice of one or more of these techniques depends primarily on the patient, the type of cancer, and the tumor location. In many situations, chemotherapy may be the primary or sole form of treatment in neoplastic disease, especially for certain advanced or inoperable tumors, or in widely disseminated forms of cancer, such as leukemia or lymphoma.6 In other situations, chemotherapy is used in combination with other techniques, such as an adjuvant to surgery and radiation treatment.18,27 Primary examples of adjuvant cancer chemotherapy include using anticancer drugs following a mastectomy or surgical removal of other carcinomas.19,54,43,61... 

Medulloblastomas Pheochromocytomas Medullary thyroid carcinomas Small-cell lung cancers Lung carcinoid tumors Pituitary adenomas Congenital mesoblastic nephroma Multiple myelomas T-cell malignant lymphomas Leukemias (AML)... 

Cancer treatment is a multimodality treatment, i.e., surgery is combined with radiotherapy and antineoplastic chemotherapy. The latter treatment mode is used mainly for cancers which have disseminated. Different forms of cancer differ in their sensitivity to chemotherapy with antineoplastic agents. The most responsive include lymphomas, leukemias, choriocarcinoma and testicular carcinoma, while solid tumors such as colorectal, pancreatic and squamous cell bronchial carcinomas generally show a poor response. The clinical use of antineoplastic agents is characterized by the following principles. 

Patients with Li-Fraumeni syndrome have increased susceptibility to a variety of cancers, including bone and soft-tissue sarcomas, breast tumors, brain cancers, leukemia, and adrenocortical carcinoma, all arising at an early age (often before 30 years). 

Osteosarcoma has recently been diagnosed in a 12-year-old girl. Family history indicates that her paternal aunt died of breast cancer at age 29 after having survived treatment for an adrenocortical carcinoma. An uncle died of a brain tumor at age 38 and the patient s father, age 35, has leukemia. 

Patients with other types of unresectable cancer also may benefit from chemotherapy, as evidenced by prolongation of life, shrinkage of tumor, and improvement in symptoms. Notable among these are ovarian epithelial and breast carcinomas, oat cell (small cell undifferentiated) carcinoma of the lung, and acute myelocytic leukemia. Cancers that are for the most part resistant to today s agents include melanoma, colorectal and renal carcinomas, and non-oat cell cancers of the lung. 

A recombinant IFN-P, IFN-pia (Rebif Serono and Avonex Biogen) is produced for commercial use in Chinese hamster ovary (CHO) cells. A synthetic mutant produced in bacteria has a substitution of serine for cysteine at amino acid 17, yielding IFN-pib Betaseron Berlex). Both IFN-pia and IFN-pib are approved by the FDA for treatment of multiple sclerosis (MS) and have shown comparable biological activity (see Section 7.3). In vivo IFN-a2 and IFN-alb show comparable biological activity as well as similar side effects [54,55]. However, IFN-P is eliminated faster, resulting in no detectable serum peak levels [56]. The clinical consequence of this is not known. Objective responses, whether partial or complete tumor regression, have been documented in patients with carcinoma of the breast, hairy-cell leukemia, and non-small-cell lung cancer [57,58]. 

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