Ketoconazole and Flutamide in the treatment of disseminated intravascular clotting from prostate cancer: a case report and review.

Disseminated intravascular clotting (DIC) is a well-recognized complication of malignancy. Prostatic cancer can produce chronic DIC as well as acute severe DIC. Treatment of DIC are general supportive measures including heparin, transfusion of blood, platelets and clotting factors, but the most important aspect is correction of underlying malignant diseases i.e. cancer of the prostate gland. For metastatic prostatic cancer presenting with an emergency oncologic condition, the treatment of choice is surgical orchiectomy, but surgery may not be possible in the presence of severe DIC. Ketoconazole and Flutamide are drugs with different mechanisms for hormonal manipulation of this cancer. Due to severe DIC, we combined both drugs trying to put maximum therapeutic effect on this life threatening profound DIC patient.

Uracil with ftorafur and low dose oral folinic acid in advanced colorectal cancer.

BACKGROUND: Low dose oral Folinic acid was used together with uracil with ftorafur (UFT) producing some response with low toxicity in advanced colorectal cancer. However, the 28 day regimen produced 20 per cent severe (grade III, IV) diarrhea. This study required 21 days' treatment to evaluate the response rate and toxicity in advanced colorectal cancer. METHOD: UFT 300 mg/m2/day together with oral Folinic acid 7.5 mg/dose for 21 days with 7 days rest were required to treat 28 cases of recurrent or metastatic colorectal cancer. RESULTS: Partial response was seen in 13.6 per cent of 22 evaluable cases and minimal response seen in 18.2 per cent. The majority (77%) of these patients had previously been treated with 5-fluorouracil (5-FU). These results are comparable to other studies. Toxicity was low with 3.3 per cent grade III, IV diarrhea. CONCLUSION: This regimen produced some activity in metastatic colorectal cancer with low toxicity.

Serum c-erbB-2 protein in breast cancer patients.

Measurements of c-erbB-2 protein were done in sera of 20 normal women, 22 benign breast disease patients and in respectively 43 and 51 samples from primary breast cancer patients obtained prior to and after surgical interventions. Mean value of serum c-erbB-2 in non-malignant women was insignificantly different from the value in the breast cancer group. Positivity rate of serum c-erbB-2 in the cancer group was 13.8 per cent. Increasing postoperative serum c-erbB-2 concentrations were in good association with severity, progressiveness and relapse of breast cancer independently of other variables such as age, menopausal status, tumor size, axillary node invasion, ER or PR status. Pretreatment serum c-erbB-2 positivity was inversely correlated to ER status but relation to other prognostic parameters of breast cancer was not found. Agreement between c-erbB-2 measured in serum by enzymeimmunoassay and in tissue by immunohistochemical assay was also found. Our data confirmed that in primary breast cancer patients, monitoring of circulating c-erbB-2 protein levels after operation are useful for detecting the recurrence and/or metastasis of the disease especially in ER positive breast cancer. Pretreatment serum c-erbB-2 concentrations do not have benefit for early diagnosis of the tumor.

Ondansetron: prevention of nausea & vomiting in cisplatin based chemotherapy.

Ondansetron in the prophylaxis of Cisplatin-induced emesis and nausea. The 5-HT3 antagonist ondansetron clearly offers a new approach to the control of Cisplatin-induced emesis and has been evaluated in Thailand. To evaluate anti-emetic efficacy of ondansetron in the prevention of nausea and vomiting induced by Cisplatin containing cancer chemotherapy regimen, we carried out an open multicentre study from January 1991 to December 1992. In this study, patients receiving Cisplatin based chemotherapy received ondansetron 32 mg as a single intravenous dose over 15 minutes prior to the administration of Cisplatin. This was followed by oral ondansetron 8 mg three times a day, preferably one hour before each meal for 5 days. All patients were chemotherapy naive in-patients and were at least 18 years or older with Karnofsky performance status of at least 60 per cent. The number of emetic episodes, nausea and food intake were recorded during the 24 hours following Cisplatin administration. A total of 103 patients were recruited with 84 (81.6%) evaluable patients (48 men and 36 women) scheduled to receive cisplatin chemotherapy at dose 60 mg/m2 or more (60-100 mg/m2), either as single agent or combination therapy. Complete response (complete control of emesis) was achieved in 60 per cent; major response (1-2 emetic episodes) was 13 per cent; minor response (3-5 emetic episodes) was 13 per cent; and failure (5+ emetic episodes) was 10 per cent. Side effects were very mild and not significant. We conclude that ondansetron is efficacious in protecting patients from Cisplatin induced emesis and nausea.