Efficacy and safety of erlotinib HCl, an epidermal growth factor receptor (HER1/EGFR) tyrosine kinase inhibitor, in patients with advanced ovarian carcinoma: results from a phase II multicenter study.

The aim of this single-arm, phase II study was to estimate the tumor response rate and safety profile of erlotinib HCl (erlotinib, Tarceva, OSI-774) monotherapy in patients with refractory, recurrent, HER1/EGFR-positive epithelial ovarian tumors, who had failed prior taxane and/or platinum-based chemotherapy. Thirty-four patients received 150 mg erlotinib orally once daily for up to 48 weeks or until disease progression or dose-limiting toxicity. Two patients had partial responses, lasting 8+ and 17 weeks, giving an objective response rate of 6% (95% confidence interval [CI], 0.7-19.7%). Fifteen patients (44%) had stable disease, and 17 patients (50%) had progressive disease. Median overall survival was 8 months (95% CI, 5.7-12.7 months), with a 1-year survival rate of 35.3% (95% CI, 19.8-53.5%). Patients with rash survived significantly longer than those without (P= 0.009), correlating with rash grade. Erlotinib was generally well tolerated. The most frequent erlotinib-related adverse events were rash (68%) and diarrhea (38%). Erlotinib had marginal activity but was generally well tolerated. The safety profile appears more favorable than typically experienced with standard chemotherapeutic agents, which is encouraging in these heavily pretreated patients. Combination of erlotinib with chemotherapy or other targeted agents should be considered.

Multicenter phase II trial of weekly paclitaxel in women with metastatic breast cancer.

PURPOSE: We evaluated the safety and efficacy of weekly paclitaxel therapy in women with metastatic breast cancer in a phase II multicenter trial. Entry criteria were relatively liberal to reflect the heterogeneity of metastatic breast cancer in clinical practice. PATIENTS AND METHODS: Patients had histologically confirmed and measurable metastatic breast cancer. Up to two prior chemotherapy regimens for metastatic disease, including prior therapy with anthracyclines and taxanes and prior high-dose therapy, were allowed. Paclitaxel 80 mg/m(2) was administered weekly for 4 weeks per 4-week cycle. RESULTS: We enrolled 212 patients; 211 were assessable for toxicity and 177 were assessable for response. Ninety percent of patients had received prior chemotherapy (adjuvant, metastatic, or both), 46% of patients had three or more involved metastatic sites, and 60% of patients had visceral-dominant disease. Responses were documented on two occasions and were independently reviewed. The overall response rate (complete plus partial response) was 21.5% (95% confidence interval, 15.4% to 27.5%), with 41.8% of patients having disease stabilization. Median time to progression was 4.7 months, and overall survival in all 212 patients enrolled was 12.8 months. Therapy was well tolerated, with a 15% incidence of grade 3/4 hematologic toxicity and a 9% incidence of grade 3 neurotoxicity; other serious toxicities were rare. The response rate and toxicity profile in the 34% of patients > or = 65 years of age were similar to that of younger patients. CONCLUSION: Weekly paclitaxel therapy was well tolerated and demonstrated reasonable activity in this relatively heavily pretreated population with advanced disease. Further study of weekly paclitaxel in combination therapy is warranted.

Pulmonary manifestations of acquired immunodeficiency syndrome-associated malignancies.

Significant progress has been made in the treatment and prophylaxis of human immunodeficiency virus (HIV)-associated infections. As patients with HIV infection live longer, more cases with HIV-associated malignancies are being reported. Pulmonary complications of HIV-associated Kaposi's sarcoma and non-Hodgkin's lymphoma present clinicians with diagnostic and therapeutic challenges. Pulmonary involvement with Kaposi's sarcoma ranges from 6% to 32%. Pulmonary involvement with acquired immunodeficiency syndrome (AIDS)-related non-Hodgkin's lymphoma occurs in about 8% of cases. Symptomatic pulmonary involvement, although unusual, may necessitate aggressive intervention with chemotherapy or radiation therapy. Although survival benefit has not been seen with aggressive therapy, significant palliation of symptomatic disease has been noted. Other non-AIDS-associated malignancies in HIV-infected patients, including Hodgkin's disease and bronchogenic carcinoma, have been reported in several series. Although no conclusive epidemiological data have yet linked HIV disease with the development of these malignancies, some investigators indicate that these cancers have an altered natural history in the HIV-infected patient. A more thorough understanding of the mechanisms by which HIV alters host immunity, predisposing the host to these malignancies, will afford new insight into ways to treat these life-threatening complications of HIV disease.

Fibrotic myopathy, haematomas and scar tissue in the gaskin area of the thoroughbred.

An easy diagnostic technique for recognising fibrotic myopathy and scarring in the caudal popliteal area is described. A simplified corrective surgical technique is offered and discussed briefly. Some aspects of haematomas are reviewed.

Equine pyelonephritis and unilateral nephrectomy.

The clinical and laboratory findings of illness in a 2-year-old Thoroughbred filly are described. The treatment employed, including unilateral nephrectomy, and the macro- and microscopic findings in the diseases kidney are presented and this rare case is discussed briefly.

Sodium hyaluronate in equine traumatic arthritis.

Thirty seven intra-articular injections, each 2 ml sodium hyaluronate were made into 21 arthritic joints in 15 racing Thoroughbreds and one part-bred polo pony. One joint failed to improve at all, 16 became sound with one injection, 4 became sound with 2 injections, and 11 joints showed various degrees of response. Eleven of 14 horses became sound for flat racing. Discussion relates to the technique of using sodium hyaluronate, some clinical and pathological aspects of traumatic arthritis, joint lubrication and a brief review of some properties of sodium hyaluronate which have a bearing on arthritis.

Some thoughts on swimming horses in a pool.

Several indications for swimming horses are recalled. A satisfactory pool and the technique for its use are described. Some observations on the effect on swimming are offered.

Cube colic.

"Cube colic" is described and vain attempts to cause the problem on an experimental basis are recorded. It is concluded that not all horses are susceptible to cube colic and if colic occurs in horses being fed on cubes, it is not necessarily due to feeding of cubes. Nomenclature of bowel disorders is considered.