Bisantrene hydrochloride in gastric adenocarcinoma: A southwest oncology group study

Abstract

Because "the standard" chemotherapy for advanced gastric adenocarcinoma, the FAM combination of 5-fluorouracil, adriamycin, and mitomycin, is only minimally effective, there is a clear need for other choices. Therefore, the Southwest Oncology Group tested the new adriamycin analog, bisantrene, hoping that it might be more effective than the "parent drug." Twenty-six patients with gastric adenocarcinoma were treated on a program of every-3-week 2-hour bisantrene infusions. The starting dose was 260 mg/m2 (208 if poor risk), with subsequent doses based on prior toxicity. The regimen caused sufficient toxicity (especially local phlebitis with pain and swelling) to assure an adequate test. One person (3.8% of eligible patients) experienced a clinically useful 3-month response. He had previously had progressive disease on FAM. Nevertheless, we conclude that bisantrene is not an addition to the small list of drugs useful in the management of gastric adenocarcinoma.

Oestrogen and colonic epithelial cell growth.

“…The lack of therapeutic effect of tamoxifen in advanced large bowel cancer is therefore not surprising. 27 Oestrogen receptorfmoI/mg total protein in the gastrointestinal tract and pancreas determined by enzyme immunoassay In breast cancer expression of the proteins pS2 and ERD5 correlates with the presence of oestrogen receptor, and response to tamoxifen therapy.2829 pS2 is a peptide now recognised to participate in mucosal regeneration. ERD5 is a heat shock protein (HSP27) closely associated with oestrogen receptor.…”

The Rediscovery of Bisantrene: A Review of the Literature

“…Phase 2 trials at the NCI revealed marginal clinical benefit in a number of different tumor types, with only leukemia, non-Hodgkin's lymphoma, and breast cancer having response rates of > 10% [35]. In other trials at academic institutions; 4 trials in renal cell did not indicate clinical utility, 5 trials in lung cancer did not support the clinical use of bisantrene, 2 trials in colon cancer, in metastatic melanoma, and in liver cancer, reported negative results, as did 1 trial each in sarcoma, head and neck cancer, and gastric cancer [79][80][81][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96]. Minor activity was reported in a trial of poor prognosis patients with advanced hormone-resistant prostate cancer, with 1 of 3 patients with measureable disease responding and 3 of the remaining 11 patients having stable disease, decline is serum acid phosphatase, no increase in bone disease, or decrease in performance status or body weight [97].…”