Chemotherapy doxorubicin

G. Other applications Herceptin has been combined with cisplatin in the treatment of heavily pretreated metastatic breast cancer. Treatment of patients with ovarian cancer is under investigation. A recent study demonstrated that Herceptin increased the clinical benefits of first-line chemotherapy—doxorubicin (or epiru-bicin) and cyclophosphamide or pacli-taxel—in metastatic breast cancer that overexpressed HER2. 

Acute febrile interstitial pneumonitis occurred within less than 48 hours after the second to fourth cycles of chemotherapy (doxorubicin, cyclophosphamide, bleomycin, methotrexate, plus methylprednisolone) in five patients with non-Hodgkin s lymphoma who were receiving prophylactic G-CSF n — 3) or GM-CSF (n = 2) (23). Lymphocytic alveolitis was confirmed in four of these patients and all three patients tested had an increased number of CD8+ T cells. Even though all the patients received high-dose methylprednisolone, two died as a result of diffuse and extensive interstitial pulmonary fibrosis, demonstrated at postmortem. Although both G-CSF and GM-CSF can cause acute pneumonitis in patients with cancers, it is still unknown to what extent hemopoietic growth factors are involved in this complication. 

Tumors with HER-2 overexpression are usually highly sensitive to the anthracy-cline chemotherapy (Doxorubicin, Epirubicin) and have an enhanced response to the taxane chemotherapy (paclitaxel). 

Laminas (LMN-ACO) serve as scaffolds for the anchoring of nuclear chromatin. Neuroblastoma cells with lamina genes deleted and lacking nuclear lamina, fail to differentiate in response to retinoic acid treatment. Lamina-defective neuroblastoma xenografts released cells with accelerated locomotion lamina-free tumor cells formed large tumors rapidly, and exhibited resistance to chemotherapy (doxorubicin, etoposide, paclitaxel). Laminary structures in place were necessary for organ differentiation [1627]. 

Storm, G. (1987). In Liposomes as Delivery System for Doxorubicin in Cancer Chemotherapy. (Ph.D. Thesis.) University of Utrecht, The Netherlands. 

The rapidly proliferating cells of the GI tract make them susceptible to the effects of chemotherapy. Mucositis is the inflamed, ulcerated mucosa of the mouth, esophagus, and lower GI tract that may result in infection and pain with subsequent decreased fluid and nutritional intake. Methotrexate, 5-FU, etoposide, and doxorubicin are the chemotherapy agents most commonly associated with mucositis. Patients should be instructed on good oral mouth care and use saline rinses several... 

Approximately 50% to 60% of women who have not received prior chemotherapy for metastatic disease will respond to chemotherapy regimens doxorubicin- and taxane-containing regimens are the most active. 

P2-microglobulin concentration have been correlated with survival. The International Index is a predictive model for aggressive NHL to be treated with doxorubicin-containing chemotherapy regimens.11 This index is used as a tool for selecting therapy for patients who may warrant a more intense treatment regimen based on known poor prognostic factors. 

In an attempt to reduce relapse rate and late toxicity, combined-modality therapy using lower doses of radiation and an abbreviated course of chemotherapy has been evaluated.16 The goal of decreased relapse rate has been achieved, but no overall survival benefit has been documented. A limitation of this approach is exposing patients to the additive toxicities of chemotherapy. Trials that have investigated this approach typically have incorporated between two and four cycles of a standard regimen for HL, such as ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) with involved-field radiation. At present, combined-modality therapy is considered to be a standard of care for stage I/II HL. 

The goal of induction chemotherapy in AML is essentially identical to that in ALL Empty the bone marrow of all hematopoietic precursors, and allow repopulation with normal cells. The combination of an anthracycline (e.g., daunorubicin, doxorubicin, or idarubicin) and the antimetabolite cytarabine forms... 

JM is a 32-year-old woman who was recently diagnosed with stage IIIB Hodgkin s disease. She comes to the clinic to receive her first dose of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy. She currently does not have a central access device therefore, she will receive her chemotherapy via peripheral vein. 

Recurrent SCLC is usually less sensitive to chemotherapy. If recurrence is more than 6 months after induction chemotherapy, the original regimen can be repeated. If recurrence occurs in less than 6 months but >3 months, treatment options include a taxane, gemcitabine, topotecan, irinotecan, CAV (cyclophosphamide, doxorubicin, and vincristine), and vinorelbine. 

Standard combination regimens (e.g., CHOP) yield disappointing results. Newer approaches including dose-adjusted EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin), and rituximab-containing combination chemotherapy are promising. 

Steiniger SC, Kreuter J, Khalansky AS, Skidan IN, Bobruskin AI, Smirnova ZS, Severin SE, Uhl R, Kock M, Geiger KD, Gelperina SE (2004) Chemotherapy of glioblastoma in rats using doxorubicin-loaded nanoparticles. Int J Cancer 109 759-767... 

THC is effective in several chemotherapy regimens, including methotrexate and the doxorubicin/cyclophosphamide/fluorouracil combination. Cisplatin treatment, however, is more resistant. Side effects of THC are generally well tolerated, and use may be limited in the elderly or with higher doses. Nabilone is a synthetic cannabinoid that is more effective than prochlorperazine in chemotherapy-induced emesis, including cisplatin. Its side effects are similar to THC. Levonantradol is another synthetic cannabinoid with antiemetic effects, and may be administered orally or intramuscularly. The side effect of dysphoria may limit its use. 

Jones, S.E. (Ed.) Current Concepts in the Use of Doxorubicin Chemotherapy, Farmitalia Carlo Erba, Milano 1982. 

The NCIC randomized patients to radiation therapy started either early or late with concurrent chemotherapy (cyclophosphamide, doxorubicin, and vincristine alternating with cisplatin and etoposide) (6). The radiation therapy dose was 40 Gy given in 15 fractions over three weeks with the cisplatin and etoposide portion of the chemotherapy. In the early arm the radiation was started on d 21 of cycle 2 (after the first cycle... 

The EORTC randomized patients to either start radiation therapy during wk 6 (early) or after the chemotherapy during wk 14 (late). The chemotherapy regimen used was cyclophosphamide, doxorubicin, and etoposide. The dose of radiation given in the early arm was 50 Gy in 20 fractions in 89 d. The dose of radiation given in the late arm was 50 Gy in 20 fractions in 26 d. No significant differences were noted for local recurrence (50.5% early radiation vs 45.5% late radiation) or 3-yr survival (14% for both early and late radiation therapy) (51). 

Thoms, 1989 (43) 61 Doxorubicin-based induction - mastectomy -> adjuvant chemo -> RT 5 yr DFS 27% 39% of patients failed to respond to induction chemotherapy. Mastectomy not associated with improved local control or survival. 

Kuerer HM, Newman LA, Smith TL, et al. Clinical course of breast cancer patients with complete pathologic primary tumor and axillary lymph node response to doxorubicin-based neoadjuvant chemotherapy. J Clin Oncol 1999 17 460 -69. 

Maloisel F, Dufour P, Bergerat JP, et al. Results of initial doxorubicin, 5-fluorouracil, and cyclophosphamide combination chemotherapy for inflammatory carcinoma of the breast. Cancer 1990 65 851-855. 

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