ABSTRACT
The neural cell adhesion molecule (NCAM) is highly expressed on the surface of small-cell-lung cancer (SCLC) cells. We have produced a monoclonal antibody, NY3D11, that binds to NCAM to investigate whether this antigen could be used to develop antibody-directed therapy for SCLC. 125I-labelled IgG and F(ab')2 fragments of NY3D11 localized selectively in human SCLC xenografts grown in nude mice. The human biodistribution of 131I-labelled NY3D11 after intravenous administration was investigated by gamma-camera imaging in six patients with SCLC. Three patients received IgG and three received F(ab')2. No evidence of localization to primary tumours or metastases was seen and antibody accumulated rapidly in the liver and bone marrow. The probable explanation for this distribution is that NY3D11 reacted with soluble NCAM or natural killer cells that possess the CD56 (NCAM) antigen.
Subject(s)
Antibodies, Monoclonal/pharmacokinetics , Carcinoma, Small Cell/metabolism , Lung Neoplasms/metabolism , Neoplasm Proteins/immunology , Neoplasm Proteins/metabolism , Neural Cell Adhesion Molecules/immunology , Neural Cell Adhesion Molecules/metabolism , Adult , Aged , Aged, 80 and over , Animals , Bone Marrow/immunology , Female , Flow Cytometry , Humans , Immunoglobulin G/metabolism , Mice , Mice, Nude , Middle Aged , Neoplasm Transplantation , Organ Specificity , Tissue Distribution , Transplantation, HeterologousABSTRACT
Endobronchial therapy is commonly used in the palliative management of malignant disease, but the optimal combinations of treatment modalities (laser, brachytherapy, external beam radiotherapy) have not been defined. We have undertaken a prospective analysis of symptom response, duration of response, and prognostic factors for 117 patients treated with brachytherapy at a single centre, to identify hypotheses suitable for prospective randomised studies. All but one patient had received previous treatment. The percentage of patients with scores of 0 or 1 (none or mild) for each symptom pre-treatment and at 3 months were as follows: cough 62% to 77% (43% improving by at least one grade, N.S.); dyspnoea 32% to 56% (50% improvement by at least one grade, P = 0.0063); haemoptysis 78% to 97%; performance status 65% to 84% (54% by at least one grade, P = 0.0417). An actuarial risk of fatal haemoptysis at 2 years of 20% was associated with prior laser resection (P = 0.048). Death before 2 months was associated with dyspnoea scores of 3 or 4. Suggestions for randomised studies are made to address some of the uncertainties revealed by the analysis.
Subject(s)
Brachytherapy , Laser Therapy , Lung Neoplasms/radiotherapy , Lung Neoplasms/surgery , Combined Modality Therapy , Follow-Up Studies , Hemoptysis , Humans , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Neoplasm Metastasis , Neoplasm Recurrence, Local , Palliative Care , Prognosis , Prospective Studies , Respiratory Function Tests , Retrospective Studies , Survival Rate , Time FactorsABSTRACT
Although alpha-interferons have anti-tumour activity in a variety of solid and haematological malignancies, they are not generally considered to be effective therapy for mature testicular teratomas. We report a case of complete remission in a patient with recurrent mature teratoma following treatment with alpha-interferon.
Subject(s)
Interferon-alpha/therapeutic use , Neoplasm Recurrence, Local/therapy , Pelvic Neoplasms/therapy , Teratoma/therapy , Testicular Neoplasms/therapy , Adult , Humans , Male , Pelvic Neoplasms/secondary , Teratoma/secondaryABSTRACT
PURPOSE: This report describes the toxicity and feasibility of administering doxorubicin (DOX) and cisplatin (CDDP) at 2-week intervals with granulocyte colony-stimulating factor (G-CSF) to patients with osteosarcoma and the compatibility of this regimen with endoprosthetic surgery performed after three cycles. PATIENTS AND METHODS: Twenty-four patients with biopsy-proven osteosarcoma were treated with three preoperative cycles of DOX 25 mg/m2/d on days 1 to 3 and CDDP 100 mg/m2 on day 1 with G-CSF 5 micrograms/kg/d on days 4 to 14. Surgery was scheduled at week 6 to be followed by three further cycles of chemotherapy at 2-week intervals. RESULTS: Two-week chemotherapy was feasible, but delays and dose reductions only allowed 74% and 78% of the intended dose-intensity of DOX and CDDP to be administered. Thrombocytopenia accounted for 50% of delays. Significant toxicity included neutropenic sepsis, severe mucositis, prolonged nausea and vomiting, and electrolyte disturbances. Twenty-one limb-salvage procedures and one amputation were performed. There were eight episodes of excessive perioperative bleeding. CONCLUSION: Intensive 2-week chemotherapy with intercurrent surgery is feasible and allows a greater dose-intensity of chemotherapy to be administered compared with the same regimen administered at 3-week intervals without G-CSF. The toxicity is considerable, but manageable.
