Solid tumour malignancy

The safety and immunogenicity of the heat-treated zoster vaccine was assessed in a randomised, double-blind, placebo-controlled, multicenter study in a diverse population of immunocompromised adults (with solid tumour malignancy (STM), haematological malignancy (HM), HIV, or recipients of autologous haematopoietic stem-cell transplant (HCT) or allogeneic HCT). Importantly, this study showed that in all groups the heat-treated zoster vaccine... 

It is rapidly absorbed from GIT after oral administration and is completely and rapidly metabolised. It is indicated in Hodgkin s disease, brain tumour, lung carcinoma, solid tumours and malignant melanoma. 

Figure 13.1. Macroscopic and microscopic appearance of solid tumours, a A metastasis of an intestinal tumour in the liver. The tumour is the bright blob ins the center, showing irregular tissue organization, and yellowish fat deposits and cavities resulting from cell degeneration. The tumour grows invasively into the surroimding liver tissue, b Microscopic picture of a malignant epithelial (squamous cell) tumour. Note the very irregular size and shape of nuclei and of cells.

Csaki C, Ferenez T, Schuler D, Borsi JD. Recombinant human erythropoietin in the prevention of chemotherapy-induced anaemia in children with malignant solid tumours. Eur J Cancer 1998 34(3) 364-7. 

Bisphosphonates are widely used for the prevention and treatment of osteopenia and osteoporosis and for the reduction of skeletal complications in patients with malignant bone disease. Several oral bisphosphonates, including alendronate, risedronate, and ibandronate, are approved worldwide for the treatment of osteoporosis in postmenopausal women, as are intravenous (i.v.) formulations of ibandronate (3 mg quarterly) and zoledronic acid (5 mg annually). Several i.v. bisphosphonates are available for the treatment of the skeletal complications that frequently occur in malignant disease, such as hypercalcaemia of malignancy (HCM), multiple myeloma, and bone metastases associated with solid tumours. Pamidronate is approved worldwide for the treatment of HCM, multiple myeloma, and breast cancer bone metastases. Although not registered for oncology indications in the United States, i.v. ibandronate is widely available elsewhere for HCM and breast cancer bone metastases. 

AE = Adverse event BC = Breast cancer CLOD = Clodronate EHDP = Etidronate HCM = Hypercalcaemia of malignancy IBN = Ibandronate i.v = Intravenous LC = Lung cancer MM = Multiple myeloma OST = Other solid tumours (renal, head and neck, thyroid, other) PDB = Paget s disease of bone PAM = Pamidronate PC = Prostatecancer PLA = Placebo PMO = Postmenopausal osteoporosis RIS = Risedronate ZOL = Zoledronicacid. 

Tumorigenicity Type 2 diabetes and use of insulin is a well-established risk factor for the development of malignancy. [S l One of the largest observational studies so far identified more than 60,000 diabetic patients and showed that patients on insulin were more likely to develop solid tumours than those on metformin with an adjusted hazard ratio (HR), 1.08 (95% confidence interval Cl 0.96-1.21) for metformin plus sulphonylurea, 1.36 (95% Cl 1.19-1.54) for sulphonylurea monotiierapy, and 1.42 (95% Cl 1.27-1.60) for insulin-based regimens,... 

Usually some 50% of malignant tumours in man initiate colonies in remote sites. Hence chemotherapy, which used to be reserved for terminal cases, is now introduced at the beginning of treatment, as soon as the mass of a solid tumour has been removed by surgery or radiation. This is done because drugs can reach out, far beyond the surgeon s knife and radiotherapist s rays, to destroy metastatic colonies of cancer cells anywhere in the body. Some 50 anti-cancer drugs have now been established as clinically useful (see Sections 5.0 and 6.3f). 

In particular, malignant human ovary and mammary carcinomas can form solid aggregates with histological similarities to the primary tumours (Schleich, 1967). In addition, the production of extracellular matrix components similar to tumours in vivo has been demonstrated by Glimelius et al (1988) with multicellular spheroids of human glioma cells. 

Ehrlich tumours are poorly differentiated malignant tumours (originally a breast carcinoma in a mouse), which grow in solid and ascetic forms. HeLa cells are a cell line developed from cervical cancer of a woman ( enriette Lacks), who died from that cancer in 1951. 

Vaupel P (1992) Physiological properties of malignant tumours. NMR Biomed 5 220-225 Vaupel P (1993) Oxygenation of solid tumors. In Teicher BA (ed) Drug resistance in oncology. Marcel Dekker, New... 

Weinmann M, Belka C, Plasswilm L (2004) Tumour hypoxia Impact on biology, prognosis and treatment of solid malignant tumours. Onkologie 27 83-90... 

The prevalence of solid benign liver tumours has been reported to be more than 20% in autopsy series and in patients with malignancy 25-50% of lesions under 2 cm in size are benign (Karhunen 1986 Edmunson and Craig 1987 Jones et al. 1992 ... 

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