Lung cancer treatment

TABLE 87-6. Small Cell Lung Cancer Treatment Overview60... 

The framing of risks makes a tremendous difference in their acceptance. A study reported in the New England Journal of Medicine showed that 44% of respondents would select a procedure for a lung cancer treatment when told they had a 68% chance of surviving, but only 18% would select the procedure if they were told they had a 32% chance of dying. It is no wonder that the consuming public has an inordinate fear of some food additives and pesticides, because the information is always reported in terms of increased risk rather than possible reduced risk, due to less mold or bacterial growth. 

Other non-small cell lung cancer treatments 14,000 Trastuzumub combination therapy for HER + breast cancer 37,500... 

Orita, H., Coulter, J., Lemmon, C., Tully, E., Vadlamudi, A., Medghalchi, S. M., Kuhajda, F. P. and Gabrielson, E., Selective inhibition of fatty acid synthase for lung cancer treatment, Clin Cancer Res 13 (2007) 7139-7145. 

Grande C, Villanueva MJ, Huidobro G, Casal J. Docetaxel-induced interstitial pneumonitis following non-small-cell lung cancer treatment. Clin Transl Oncol 2007 9(9) 578-81. 

L. Paleari, E. Negri, A. Catassia, et al.. Inhibition of nonneuronal alpha7-nicotinic receptor for lung cancer treatment. Am. J. Respir. CriL Care Med. 179 (12) (2009) 1141-1150. 

Fluorouracil is a chemotherapy used against some types of cancers [93]. Zhang et al., [93] developed 5-fluorouracil-loaded in biopolymer nanoparticles by reverse emulsion-SEDS, evaluated the pharmacokinetics by in vitro assays and obtained effective tumor inhibition in rats. Already Kalantarian et al., [94] used the SAS process to develop S-Fluoromacil nanoparticles for lung cancer treatment. 

The majority of promising drug candidates emerging from marine natural products research to date are potential cancer treatments. Six anti-cancer compounds that are either marine natural products or synthetic analogs of marine natural products have made it to clinical trials. The first of these compounds to enter clinical trials was didemnin B (43), one of a family of cyclic depsipetides isolated from the Caribbean tunicate Trididemnum solidum Didemnin B was advanced to Phase II clinical trials for treatment of small cell lung cancer, myeloma, prostate cancer, and melanoma. Unfortunately, no favorable responses were found so the compound has been withdrawn. Crude extracts of another Caribbean tunicate, Ecteinascidia turbinata, showed extremely... 

Nitrogen mustard is clinically used for the treatment of lymphomas and some forms of lung cancer. The major indication for mechlorethamine is Hodgkin s disease as a part of the MOPP regimen (mechlorethamine + vincristine (oncovin) + procarbazine + prednisone). The usual dose consists of 6 mg/m2 on days 1 and 8. This drug has pronounced hematological toxicity (myelo-suppression). 

The usual dose consists of 1000 mg/m2 i.v. It is the most active single agent for treating pancreatic cancer, and it is used as a fust-line treatment for both pancreatic and small cell lung cancers. The dose-limiting toxicity is bone marrow suppression. 

These arotinoids, which were first introduced for the treatment of skin diseases, may also have potential as anticancer diugs. For example, the synthetic retinoid 6-[3-(l-adamantyl)-4-hydroxyphenyl]-2-naphthalene carboxylic acid (CD437) has been shown to induce apoptosis in a variety of cancer cells including lung cancer cells in vitro, and studies concerning the use of this agent in vivo would be desirable. 

Anodier problem can arise from the use of nonprescription cough medicine for self-treatment of a chronic cough. Indiscriminate use of antitussives by die general public may prevent early diagnosis and treatment of serious disorders, such as lung cancer and emphysema... 

The a-tocopherol, P-carotene (ATBC) Cancer Prevention study was a randomised-controlled trial that tested the effects of daily doses of either 50 mg (50 lU) vitamin E (all-racemic a-tocopherol acetate), or 20 mg of P-carotene, or both with that of a placebo, in a population of more than 29,000 male smokers for 5-8 years. No reduction in lung cancer or major coronary events was observed with any of the treatments. What was more startling was the unexpected increases in risk of death from lung cancer and ischemic heart disease with P-carotene supplementation (ATBC Cancer Prevention Study Group, 1994). Increases in the risk of both lung cancer and cardiovascular disease mortality were also observed in the P-carotene and Retinol Efficacy Trial (CARET), which tested the effects of combined treatment with 30 mg/d P-carotene and retinyl pahnitate (25,000 lU/d) in 18,000 men and women with a history of cigarette smoking or occupational exposure to asbestos (Hennekens et al, 1996). 

The vesicant vinorelbine is structurally similar to vincristine and may cause many of the same side effects as vincristine. While this vesicant is administered intravenously over 6 to 10 minutes, patients should be counseled about neuropathy, ileus, and myelosuppression. The pharmacokinetics of vinorelbine are best described by a three-compartment model, with an a half-life of 2 to 6 minutes, a 3 half-life of 1.9 hours, and a y half-life of 40 hours. Vinorelbine has shown efficacy in the treatment of breast cancer and non-small cell lung cancer. Additional side effects include myelosuppression, paresthesias, and mild nausea and vomiting. 

Etoposide causes multiple DNA double-strand breaks by inhibiting topoisomerase II. The pharmacokinetics of etoposide are described by a two-compartment model, with an a half-life of 0.5 to 1 hour and a (5 half-life of 3.4 to 8.3 hours. Approximately 30% of the dose is excreted unchanged by the kidney.16 Etoposide has shown activity in the treatment of several types of lymphoma, testicular and lung cancer, retinoblastoma, and carcinoma of unknown primary. The intravenous preparation has limited stability, so final concentrations should be 0.4 mg/mL. Intravenous administration needs to be slow to prevent hypotension. Oral bioavailability is approximately 50%, so oral dosages are approximate two times those of intravenous doses however, relatively low oral daily dosages are used for 1 to 2 weeks. Side effects include mucositis, myelosuppression, alopecia, phlebitis, hypersensitivity reactions, and secondary leukemias. 

Topotecan inhibits topoisomerase I to cause single-strand breaks in DNA. The pharmacokinetics of topotecan can be described by a two-compartment model, with a terminal half-life of 80 to 180 minutes, with renal clearance accounting for approximately 70% of the clearance.19 Topotecan has shown clinical activity in the treatment of ovarian and lung cancer, myelodysplastic syndromes, and acute myelogenous leukemia. The intravenous infusion may be daily for 5 days or once weekly. Side effects include myelosuppression, mucositis, and diarrhea. 

Altretamine has shown activity in the treatment of ovarian and lung cancer. This orally administered drug has the dose-limiting side effects of anorexia, nausea, vomiting, diarrhea, and abdominal cramping. Other side effects include neuropathy, agitation, confusion, and depression. 

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