Lomustine Research Articles

Nüks Yapmış Beyin Tümörlerinde Kemoterapi Sonuçlarının Değerlendirilmesi

Chemotherapy in Recurrent Brain Tumors Six patients were admitted to medical oncology department of the Ondokuz Mayiz Univer-sity Medical School with recurrent primary brain tumors and, received a chemotherapy protocol consisting of procarbazine, vincristine and lomustine (or carmustine). All patients were previously treated by surgery and radiotherapy, and their ECOG performances were 0-1. Six to thirteen cycles of chemotherapy was given. Response was evaluated according to computed tomography and clinical findings. Complete response was obtained in three patients, in the remaining three; response to chemotherapy was partial. Ondokuz Mayyis Universitesi Tip Fakultesi Medikal Onkoloji bolumune basvuran 6 beyin tumorlu olgu prokarbazine, vincristine ve lomustine (ya da carmustine)'den olusan kemo-terapi protokolunu aldilar. Protokole onceki tedavilere (cerrahi ve radyoterapi) ragmen tek-rarlayan beyin tumoru olan olgular alindi. ECOG performanslari 0 ile 1 arasinda degisi¬yordu. Alti ila onuc kur arasi kemoterapi yapildi. Olgular radyolojik ve klinik olarak izlen¬di. Olgularin uc tanesinde tam cevap (TC), uc tanesinde ise kimsi cevap (KC) elde edildi.

Phase II study of lomustine, cytarabine, mitoxantrone, and prednisone (CAMP) combination chemotherapy for doxorubicin-resistant intermediate- and high-grade malignant non-Hodgkin's lymphoma.

A phase II study was conducted to evaluate the efficacy and toxicity of lomustine, cytarabine, mitoxantrone and prednisone (CAMP) chemotherapy in doxorubicin-resistant intermediate- and high-grade malignant non-Hodgkin's lymphomas (NHL). Among 30 patients, the complete remission rate was 27% (duration: 10, 16, 22, 35, 35+, 42+, 51+, 55+ months) and the partial remission rate was 20%. Median survival for complete responders was more than 4 years. The best responses were seen in patients with relapsed NHL compared to those with primary refractory NHL. Toxicity was mainly related to myelosuppression. The results suggest that the CAMP schedule can be applied on an outpatient basis with satisfactory efficacy in patients with relapsing intermediate- and high-grade malignant NHL.

Can MOPP be replaced in the treatment of advanced Hodgkin's disease?

MOPP (mechlorethamine, vincristine, procarbazine, prednisone) was the first successful regimen for the treatment of Hodgkin's disease. It has the longest period of follow-up and is best studied as to its benefits and acute and long-term side effects. The acute toxicity of the side effects, including nausea and/or vomiting, hair loss, and myelosuppression, may have been reason to modify doses of nitrogen mustard, an agent whose dose intensity may be critical in achieving long-term benefits. The substitution of chlorambucil and vinblastine in the ChlVPP (chlorambucil, vinblastine, procarbazine, prednisone) program has relieved all of these acute toxicities, except myelosuppression. The long-term toxicity of sterility, especially in males, and myelodysplasia is most likely due to alkylating-agent toxicity and would not be influenced by the various MOPP variants, such as MVPP (mechlorethamine, vinblastine, procarbazine, prednisone), ChlVPP, and COPP (chlorambucil-vincristine, procarbazine, prednisone). Doxorubicin-containing regimens, such as ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) and ABDIC (doxorubicin, bleomycin, dacarbazine, lomustine, prednisone), have been second-line treatments that have significant antitumor effect and, as such, have resulted in few, if any, long-term cures in most series. ABVD has been incorporated into alternating MOPP/ABVD schemes or in hybrids that attempt to offer all active agents, such as MOPP/ABV. The initial experience has been encouraging with high and durable complete remissions (CRs). MOPP/ABVD x 12(1) and MOPP-2/ABVD-2(2) have been compared with MOPP alone with a significant superiority for the alternating regimens. Other randomized trials have not shown any superiority for the alternating program. The Cancer and Leukemia Group B (CALGB) has compared MOPP with MOPP/ABVD given with a third arm of ABVD alone. The complete response and time-to-treatment failure rates for MOPP/ABVD and ABVD alone were superior to those for MOPP. Significant modifications of MOPP doses may explain the differences, since only 20% of patients were receiving full doses of nitrogen mustard by the sixth dose. ABVD has unique toxicity, and myelodysplasia and sterility are not seen. Pulmonary fibrosis with radiation and bleomycin is unique to ABVD, as shown in the ABVD experience at the NCl (Milan). Can ABVD be improved? The demonstrated single-dose activity of etoposide in Hodgkin's disease has prompted its inclusion in second-line programs, such as EVA (etoposide, vincristine or vinblastine, doxorubicin). The second-line response rates in the St Bartholomew's (London, England) series (where vincristine was used) was 11 of 19 patients (58%);3 in the ongoing CALGB trial of EVA (vinblastine combination), the response rate is 67%. (ABSTRACT TRUNCATED AT 400 WORDS)

Potentiation of Cytotoxicity of Anticancer Agents by Several Different Polyene Antibiotics<xref ref-type="fn" rid="FN2">2</xref>

The ability of several different polyenes to potentiate the cytotoxicity of carmustine, lomustine (LOM), and doxorubicin (DX) against AKR mouse leukemia was quantitated. All polyenes could potentiate the cytotoxicity of the anticancer agents; however, the methyl ester derivatives of the heptaenes amphotericin B and candicidin and the triene trienine were most effective with potentiations in the order of ten thousandfold for DX and LOM. A steep dose-response relationship for the polyenes was also noted. Neither the toxicity of the polyenes nor their level of potentiation could be correlated with structure or class.

Prognostic implications of stage of disease and sites of metastases in patients with small cell carcinoma of the lung treated with intensive combination chemotherapy.

The influence of various sites of distant metastases on response and survival was analyzed in 106 consecutive previously untreated patients with small cell carcinoma whose disease was systematically staged. All patients received 6 wk of intensive induction chemotherapy with cyclophosphamide, methotrexate, and lomustine; therapy thereafter varied without differential effects on survival. Staging procedures included physical examination, chest roentgenogram, fiberoptic bronchoscopy, bone marrow and liver biopsies, and radionuclide bone, brain, and liver scans. On the basis of pretreatment staging, 33 patients (31%) had limited disease. In the remaining 73 patients, sites of extensive disease included bone in 40; with bone as the sole site of metastatic disease in 13; liver in 30, with liver as the only site in 5; soft tissues in 25 (only site in 7); bone marrow in 22 (only 2); central nervous system in 9 (only site in 4); opposite lung in 7 (only site in 4). Although patients with limited disease live longer than those with extensive disease (median length of survival, 12 versus 10 months), this difference was not significant. This lack of major impact of traditional stage on survival was explained by the similar survival of patients with limited disease and a single site of extensive disease. Prognosis worsened with increasing number of sites of extensive disease (median survival, 11.5, 10, and 8 months for one, two, and three or more sites, respectively). Metastases to the liver or central nervous system significantly shortened survival, whereas involvement of bone, soft tissues, or bone marrow had little adverse effect. In patients with small cell carcinoma whose disease is thoroughly staged and who are given aggressive chemotherapy, certain sites or a small number of sites of extensive disease may be treated as successfully as limited disease.