Etoposide | Health and Prostate

Posts Tagged ‘Etoposide’

Testicular Cancer

Posted by admin on October 28th, 2011 No Comments

A germ cell tumour of the testis is a rare disease although it is the most common tumour in men aged 20-35 years. The incidence of testicular cancer is about 4-5 per 100000 men per year, but there is a geographical and racial variation. Most patients present themselves with a painless lump in the testicle. Sometimes the first symptoms are related to retroperitoneal lymph node metastasis (back pain) or to lung metastasis (haemoptysis or breathlessness). A few patients present with gynaecomastia as a result of an elevated level of the tumour marker human chorionic gonadotrophin. The diagnosis is established after an inguinal orchiectomy, and germ cell tumours are distinguished into seminomas and non-seminomas, each accounting for about 50% of the total. Staging includes, next to physical examination, computed tomographic scanning of the chest, the abdomen and the pelvis and determination of the serum levels of lactodehydrogenase, alpha-fetoprotein and human chorionic gonadotrophin. The Royal Marsden staging system is widely used [1]. In stage I there is no evidence of metastatic disease and the Read more [...]

Posted in Urological Oncology

Non-seminoma stage II-Intravenous

Posted by admin on October 28th, 2011 No Comments

Disseminated non-seminoma is highly curable. In most patients, an orchiectomy is performed before starting chemotherapy. However, if the diagnosis has been made by biopsy of a metastatic site and chemotherapy initiated, subsequent orchiectomy is generally performed due to the fact that chemotherapy may not eradicate the primary cancer. This is illustrated by case reports in which viable tumour was found on postche-motherapy orchiectomy despite complete response of metastatic lesions. After the introduction of cisplatin, vinblastine and bleomycin (PVB) combination chemotherapy, consisting of a remission-induction part and a maintenance part, the strategy for treatment outcome improvement had focused on less toxicity with similar efficacy. It was shown that the dosage of vinblastine could be reduced (0.3 mg/kg vs 0.4 mg/kg) and that maintenance chemotherapy does not prevent relapses but adds significantly to the toxicity. Later on vinblastine has been replaced by etoposide; based on the efficacy of etoposide in salvage therapy, and based on the results of a randomized Read more [...]

Posted in Urological Oncology

Treatment of recurrent disease

Posted by admin on October 28th, 2011 No Comments

Deciding on further treatment in case of recurrent testicular cancer depends on many factors, including the histology, prior treatment, site of recurrence, as well as individual patient considerations. Salvage regimens consisting of ifosfamide, cisplatin and either etoposide or vinblastine can induce long-term complete responses in about one quarter of patients with disease that has persisted or recurred following first-line cisplatin-based regimens. Patients who have had an initial complete response to first-line chemotherapy and those without extensive disease have the most favourable outcome. The VIP regimen is now the standard initial salvage regimen. However, few, if any, patients with recurrent NSGCTs of an extragonadal origin achieve long-term disease-free survival using VIP if their disease recurs. High-dose chemotherapy with autologous stem cell transplantation has also been used with some success in the setting of refractory disease. Durable complete remissions may be achievable in 10-20% of patients. The durable complete remission rate may even exceed 50% in selected patients if high-dose Read more [...]

Posted in Urological Oncology

Principles of therapy

Posted by admin on October 28th, 2011 No Comments

Selection of patients suitable to receive systemic chemotherapy Bladder cancer is a condition associated with smoking, the incidence of which rises with age with no demonstrable peak. The average age of unselected patients in large institutions is over 75 years. It is not surprising then that up to half of all patients with locally advanced/metastatic transitional cell carcinoma of the bladder are not fit to receive cisplatin-based chemotherapy. Commonly encountered reasons for this include poor renal function due to renovascular disease or obstructive uropathy due to bladder cancer, poor cardiac status, inadequate bone marrow reserve, poor performance status and a variety of comorbid conditions. Various strategies have been considered to account for this problem. These include modulation of cisplatin's nephrotoxicity by using nephro-protective agents such as N-acetyl cysteine and amifostine, modifying the scheduling of cisplatin or use of less cisplatin-intense regimens. Other strategies avoid the use of cisplatin completely (e.g. the use of the MV regimen rather than CMV), but these are Read more [...]

Posted in Urological Oncology

Mitoxantrone Hydrochloride

Posted by admin on June 24th, 2011 No Comments

C22H28N4O6•2HCl DHAD • Mitoxantrone hydrochloride, a synthetic anthracenedione, is an antineoplastic agent. Uses Mitoxantrone is used as a component of combination chemotherapeutic regimens for remission induction in acute myeloid (myelogenous, nonlymphocytic) leukemia (AML, ANLL) in adults. The drug also is used in combination with a corticosteroid in the palliative treatment of advanced, symptomatic (i.e., painful) hormone-refractory prostate cancer. Mitoxantrone should be used under the supervision of a qualified physician experienced in therapy with antineoplastic agents. Laboratory and supportive services must be available for hematologic and chemistry monitoring and adjunctive therapies, including anti-infectives; blood and blood products must be available to support patients during the expected period of medullary hypoplasia and severe myelosuppression. Particular care should be given to ensure full hematologic recovery before initiating consolidation therapy (if this treatment is used), and patients should be monitored closely during this phase. According to the manufacturer, Read more [...]

Posted in Drugs

Estramustine Phosphate Sodium

Posted by admin on June 24th, 2011 No Comments

C23H30ClNNaO6P • Estramustine phosphate sodium, a complex of 17 ?-estradiol and nornitrogen mustard, is an antimicrotubule antineoplastic agent. Uses • Prostate Cancer Estramustine phosphate sodium is used for the palliative treatment of metastatic and/or progressive prostate cancer. The drug, alone or in combination with other antineoplastic agents, currently is considered by many clinicians to be an alternative to conventional measures (e.g., orchiectomy, hormonal therapy) and generally is used in the treatment of hormone-refractory prostate cancer. Safety and efficacy of estramustine have been evaluated in controlled and uncontrolled studies in patients with advanced metastatic prostate cancer refractory to conventional measures (e.g., hormonal therapy) as well as in those with previously untreated disease. Most studies were conducted before the realization that administration of estramustine with milk or calcium-containing products substantially impairs absorption of the drug; therefore, overall clinical efficacy (i.e., objective response) of estramustine may have been underestimated. Read more [...]

Posted in Drugs

Chemotherapy and Immunotherapy

Posted by admin on June 21st, 2011 No Comments

Management of Hormone-Refractory Prostate Cancer: Chemotherapy and immunotherapy The effective treatment of prostate cancer patients with advanced disease is a major challenge. Metastatic disease can initially be effectively managed using the relatively nontoxic intervention of androgen ablation, that is, orchiectomy, diethylstilbestrol, and luteinizing hormone-releasing hormone analogues. As the response rate exceeds 80% and the approach affords little morbidity in comparison to the cytotoxic approaches necessary for the treatment of other epithelial malignancies, it is the therapy chosen by most patients and physicians. However, most patients eventually experience biochemical or clinical evidence of disease progression in a median time of 12 to 18 months. Second-line treatment options are then considered, and usually consist of additional hormonal manipulations. Despite this approach, progression is the norm with the development of androgen-independent or hormone-refractory prostate cancer. For patients with hormone-refractory prostate cancer, the prognosis is poor with a median survival of 9 Read more [...]

Posted in Chemotherapy and Immunotherapy

Combination Chemotherapy

Posted by admin on June 21st, 2011 No Comments

With a few notable exceptions, reported combinations of cytotoxic chemotherapeutic agents have added little benefit to single-agent chemotherapy in the treatment of hormone-refractory prostate cancer. It must be emphasized that early trials of combination chemotherapy were performed in the pre-prostate-specific antigen era with patients exhibiting very advanced and usually symptomatic hormone-refractory prostate cancer. In addition, an understanding of basic prostate cancer biology has provided insights for the rational selection of drug combinations such as Estramustine phosphate and paclitaxel targeting the cytoskeleton and nuclear matrix. Cytoxan + Methotrexate + 5-Fluorouracil The regimen of cytoxan (Cy), methotrexate, and 5-FU (CMF) is a combination active in epithelial malignancies including breast carcinoma. This regimen was evaluated in 52 eligible patients with measurable (19 patients), evaluable (29 patients), or bone scan only (4 patients) metastatic prostate cancer using a dosing schedule of 100 mg per m per day by mouth of cyclophosphamide, 15 mg per m weekly IV methotrexate, and Read more [...]

Posted in Chemotherapy and Immunotherapy

Posts Tagged ‘Etoposide’

Symptoms and Treatment

Drugs. Meds