Methyl-CCNU, 5-fluorouracil, vincristine, and streptozocin (MOF-STREP) in metastatic colo-rectal carcinoma.

Abstract

Forty patients with metastatic colorectal carcinoma who had received no prior chemotherapy were entered onto a trial of methyl-CCNU, 5-fluorouracil, vincristine, and streptozocin (MOF-STREP). Ten of 40 (25%) responded. Two patients (5%) achieved a complete response and eight patients (20%) a partial response. In addition, 10 patients previously treated with chemotherapy received the MOF-STREP regimen; 1 of 10 (10%) responded. The duration of the complete responses were 5 and 16 mo, respectively. The median duration of the partial responses was 4 mo with a range of 1-16 mo. The median survival of the 11 responders was 14 mo. Median survival of the 39 nonresponders was 5 months. Responders lived significantly longer than nonresponders (p = 0.03, log-rank). Toxicity was severe with nausea and vomiting common after streptozocin and myelosuppression requiring dose reductions in 70% of patients. We compare our findings using this regimen to those of two previously reported trials.

Long‐term ambulatory treatment of metastatic colorectal adenocarcinoma by continuous intravenous infusion of 5‐fluorouracil

“…Most of those previously at work resumed their occupations during infusion. Patients with PR or SD were ap-1 00 (3 proximately twice as likely (77 % and 60%) to experience subjective benefit as those with PD, although there was considerable symptomatic relief for some patients (23 %) in whom the tumor continued to grow.…”

“…Therapy with 5-fluorouracil (5-FU) typically has yielded a low objective response rate and has had a minimal impact on survival [ 11. Treatment methods employing other antitumor agents or new delivery techniques occasionally have altered tumor regression data favorably but have not improved survival consistently [2]. Associated toxicity and morbidity at times have been increased, and quality of life has been compromised beyond antitumor benefit in some instances [3].…”

Η Επίδραση Της Άσκησης Στο Καρδιαγγειακό Σύστημα Διαβητικών Επιμύων

“…Επιπλέον, υπάρχει αυξημένος κίνδυνος να προκαλέσουν δευτεροπαθείς νεοπλασίες και ανοσοκαταστολή 831. Στο παρελθόν, η STZ είχε χρησιμοποιηθεί ειδικά για τη θεραπεία νεοπλασμάτων του γαστρεντερικού και κυρίως για το ορθοκολικό καρκίνωμα, είτε μόνη της είτε μαζί με άλλα χημειοθεραπευτικά φάρμακα, αλλά παρατηρήθηκε έντονη τοξικότητα και ανοσοκαταστολή στους περισσοτέρους ασθενείς 832. Η STZ έχει εγκριθεί από τον U.S. FDA (Food and Drug Administration) για την θεραπεία του μεταστατικού καρκίνου των νησιδίων του παγκρέατος, επειδή όπως προαναφέρθηκε παρουσιάζει εκλεκτική τοξικότητα για τα β κύτταρα των παγκρεατικών νησιδίων 833.…”