Cyclophosphamide sarcomas

Clinical trials showed therapeutic efficacy in a broad spectrum of tumors these include SCLC, testicular tumors, sarcomas, breast cancer, renal cell cancer, pancreatic tumors and lymphomas. Ifosfamide is less myelosuppressive than cyclophosphamide but is more toxic to the bladder. Therefore it is recommended that ifosfamide is coadministered with the thiol compound mesna to avoid hemorrhagic cystitis and to reduce the risk of developing bladder cancer. Other side effects include neurotoxicity and myelosuppression. 

Cyclophosphamide is a component of CMF (cyclophosphamide, methotrexate, 5-fluorouracil) and other drug combinations used in the treatment of breast cancer. Cyclophosphamide in combination may produce complete remissions in some patients with ovarian cancer and oat cell (small cell) lung cancer. Other tumors in which benehcial results have been reported include non-oat cell lung cancers, various sarcomas, neuroblastoma, and carcinomas of the testes, cervix, and bladder. Cyclophosphamide also can be employed as an alternative to azathioprine in suppressing immunological rejection of transplant organs. 

Ifosfamide is active against a broad spectrum of tumors, including germ cell cancers of the testis, lymphomas, sarcomas, and carcinomas of the lung, breast, and ovary. It is thought to be more active than cyclophosphamide in germ cell cancers and sarcomas. 

Cyclophosphamide Same as above Breast cancer, ovarian cancer, non-Flodgkin s lymphoma, CLL, soft tissue sarcoma, neuroblastoma, Wilms tumor, rhabdomyosarcoma Nausea and vomiting ... 

Rapid progression of Kaposi s sarcoma 10 weeks after combined treatment with glucocorticoids and cyclophosphamide has been described marked improvement of the skin lesions was noted after discontinuation of prednisone therapy (360). 

Erban SB, Sokas RK. Kaposi s sarcoma in an elderly man with Wegener s granulomatosis treated with cyclophosphamide and corticosteroids. Arch Intern Med 1988 148(5) 1201-3. 

Ewing s sarcoma is the second most common malignant bone tumor in children. The majority of patients have microscopic metastases at diagnosis the lung is the most common metastatic site. This sarcoma is a relatively rare disease with limited therapeutic options. The majority of patients are initially responsive to chemotherapy with vincristine, doxorubicin (Adriamycin), and cyclophosphamide. However, relapsed disease is usually extremely difficult to treat because of its resistance to chemotherapy (Zhou et al., 2001). 

Osteogenic sarcoma Doxorubicin, or methotrexate with leucovorin rescue initiated after surgery Cyclophosphamide, dacarbazine, interferon, ifosfamide plus mesna1... 

Meistrich ML, Wilson G, Brown BW, da Cunha MF, Lipshultz LI (1992) Impact of cyclophosphamide on long-term reduction in sperm count in men treated with combination chemotherapy for Ewing and soft tissue sarcomas. Cancer, 70 2703-2712. 

Endometrial Ewing s sarcomao" Gastric Head and neck,squamous cell Islet cell (pancreas) Kaposi s sarcoma Doxorubicin cisplatin + cyclophosphamide CAV Cyclophosphamide (or Ifosfamide) + doxorubicin (Adriamycin) + vincristine CF epirubidri + cisplatin 5-fluorouraci1 Cisplatin + S-fluorouracil Methotrexate Screptozotocin + S-fluorouracil Etoposide or interferon affa or vinblastine ABV doxorubicin (Adriamycin) + bteomycin + vincristine or vinblastine... 

Of 17 adult men who had been treated before puberty for sarcoma with high-dose pulse cyclophosphamide (median dose 20.5 m/m ) as part of regimens containing vincristine, dactinomycin, and cyclophosphamide, with or without doxorubicin, 10 had azoospermia, five had oligospermia, and only two had normal sperm counts (34). The authors concluded that a previous suggestion that puberty acts as a protection to infertihty was not borne out and that the risk of infertihty was proportional to the cumulative dose of cyclophosphamide. 

Cyclophosphamide, or testicular and cranial irradiation, in the treatment of childhood malignancies can lead to small testicular size and decreased sperm production in adulthood (58). Of 17 adult male survivors of childhood sarcomas treated before puberty with high-dose cyclophosphamide, only two had normal sperm counts, 10 had azoospermia, and five had oligospermia (34). The two patients with normal sperm counts had taken the lowest doses of cyclophosphamide. 

Polymer (VI) has been shown to have antitumor activity against adenocarcinoma 755, Dunning ascites leukemia. Friend leukemia virus, and Lewis lung carcinoma. In the latter case, polymer (VI) showed activity about equal to that of cyclophosphamide (an alkylating agent) and was more effective than 6-mercaptopurine (an antimetabolite) ( ). The DIVEMA polymer (V) Is also active against some cancer causing viruses such as Friend leukemia, Moloney sarcoma and Rauscher leukemia ( ). 

Cyclophosphamide (Cytoxan) Breast cancer NHL ALL ANLL CLL ovarian cancer myeloma retinoblastoma neuroblastoma HD NSCLC SCLC endometrial cancer soft-tissue sarcomas BMT-preparative (high-dose) bladder cancer SLE autoimmune disorders... 

Dactinomycin is an antineoplastic agent that is the principal component of the mixture of actinomycins produced by Streptomyces parvullus. It inhibits messenger RNA synthesis. Dactinomycin (0.5 mg/day IV for 5 days), in combination with vincristine, radiotherapy, and surgery, is used in Wilms tumor in conjunction with vincristine, cyclophosphamide, and doxorubicin, it is used in choriocarcinoma in combination with methotrexate, it is used in testicular carcinoma and in combination with cyclophosphamide and radiotherapy, it is used in Ewing s sarcoma. Dactinomycin inhibits messenger RNA synthesis by anchoring to a purine-pyrimidine (DNA) base pair by intercalation (see Figure 15). The toxicity of dactinomycin increases when combined with radiation therapy. 

The most important clinical use of dactinomycin is in the treatment of rhabdomyosarcoma and Wilms tumor in children, where it is curative in combination with primary surgery, radiotherapy, and other drugs, particularly vincristine and cyclophosphamide. Antineoplastic activity has been noted in Ewing s tumor, Kaposi s sarcoma, and soft-tissue sarcomas. Dactinomycin can be effective in women with advanced cases of choriocarcinoma in combination with methotrexate. Dactinomycin also has been used as an immunosuppressant in renal transplants. 

Ewing s sarcoma Cyclophosphamide plus doxorubicin and vincristine... 

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