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1.
J Phys Condens Matter ; 33(41)2021 Aug 05.
Article in English | MEDLINE | ID: mdl-33662946

ABSTRACT

Magnonics is a budding research field in nanomagnetism and nanoscience that addresses the use of spin waves (magnons) to transmit, store, and process information. The rapid advancements of this field during last one decade in terms of upsurge in research papers, review articles, citations, proposals of devices as well as introduction of new sub-topics prompted us to present the first roadmap on magnonics. This is a collection of 22 sections written by leading experts in this field who review and discuss the current status besides presenting their vision of future perspectives. Today, the principal challenges in applied magnonics are the excitation of sub-100 nm wavelength magnons, their manipulation on the nanoscale and the creation of sub-micrometre devices using low-Gilbert damping magnetic materials and its interconnections to standard electronics. To this end, magnonics offers lower energy consumption, easier integrability and compatibility with CMOS structure, reprogrammability, shorter wavelength, smaller device features, anisotropic properties, negative group velocity, non-reciprocity and efficient tunability by various external stimuli to name a few. Hence, despite being a young research field, magnonics has come a long way since its early inception. This roadmap asserts a milestone for future emerging research directions in magnonics, and hopefully, it will inspire a series of exciting new articles on the same topic in the coming years.

2.
Br J Cancer ; 99(1): 51-6, 2008 Jul 08.
Article in English | MEDLINE | ID: mdl-18542071

ABSTRACT

The incidence of malignant pleural mesothelioma (MPM) in elderly patients is increasing. In this study, pooled data from two phase II trials of pemetrexed and carboplatin (PC) as first-line therapy were retrospectively analysed for comparisons between age groups. Patients received pemetrexed 500 mg m(-2) and carboplatin AUC 5 mg ml(-1) min(-1) intravenously every 21 days with standard vitamin supplementation. Elderly patients were defined as those >or=70 years old. A total of 178 patients with an ECOG performance status of or=70 years (27%). Grade 3-4 haematological toxicity was slightly worse in >or=70 vs <70-year-old patients, with neutropenia observed in 25.0 vs 13.8% (P=0.11), anaemia in 20.8 vs 6.9% (P=0.01) and thrombocytopenia in 14.6 vs 8.5% (P=0.26). Non-haematological toxicity was mild and similar in the two groups. No significant difference was observed in terms of overall disease control (60.4 vs 66.9%, P=0.47), time to progression (7.2 vs 7.5 months, P=0.42) and survival (10.7 vs 13.9 months, P=0.12). Apart from slightly worse haematological toxicity, there was no significant difference in outcome or toxicity between age groups. The PC regimen is effective and well tolerated in selected elderly patients with MPM.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Carboplatin/administration & dosage , Glutamates/administration & dosage , Guanine/analogs & derivatives , Mesothelioma/drug therapy , Pleural Neoplasms/drug therapy , Adult , Age Factors , Aged , Clinical Trials, Phase II as Topic , Female , Guanine/administration & dosage , Humans , Male , Middle Aged , Pemetrexed , Retrospective Studies
3.
J Phys Condens Matter ; 30(39): 394002, 2018 Oct 03.
Article in English | MEDLINE | ID: mdl-30132441

ABSTRACT

We consider here the magnetization dynamics induced in a ferromagnet by magnetoelastic coupling, after application of a step like strain. We derive the time evolution of the magnetization vector. We show that the material micromagnetic parameters (and specifically magnetic anisotropy and magnetoelastic coupling) can be derived from measurable quantities, i.e. the precession frequency, relaxation time and phase lag between the precession angles. Such measurements can be performed by state of the art time resolved Kerr experiments.

4.
J Phys Condens Matter ; 30(11): 115701, 2018 03 21.
Article in English | MEDLINE | ID: mdl-29469058

ABSTRACT

We demonstrate here a simple measurement protocol which allows the thermal properties of anisotropic crystalline materials to be determined. This protocol is validated by the measurement of Bi2Se3, a layered material consisting of covalently bonded sheets with weak van der Waals bonds between each layer, which has highly anisotropic thermal properties. Thermoreflectance microscopy measurements were carried out on a single-crystal Bi2Se3 sample, firstly on the bare sample and then after capping with a 100 nm thick gold layer. Whereas on the bare sample lateral heat diffusion is dominated by the in-plane thermal diffusivity, on the metal-capped substrate heat diffusion perpendicular to the sample surface dominates. Using a simple theoretical model, we show how this double measurement protocol allows the anisotropic thermal conductivity coefficients of bulk Bi2Se3 to be evaluated.

5.
Sci Rep ; 8(1): 9339, 2018 Jun 19.
Article in English | MEDLINE | ID: mdl-29921938

ABSTRACT

In thin magnetic films with perpendicular magnetic anisotropy, a periodic "up-down" stripe-domain structure can be originated at remanence, on a mesoscopic scale (~100 nm) comparable with film thickness, by the competition between short-range exchange coupling and long-range dipolar interaction. However, translational order is perturbed because magnetic edge dislocations are spontaneously nucleated. Such topological defects play an important role in magnetic films since they promote the in-plane magnetization reversal of stripes and, in superconductor/ferromagnet hybrids, the creation of superconducting vortex clusters. Combining magnetic force microscopy experiments and micromagnetic simulations, we investigated the motion of two classes of magnetic edge dislocations, randomly distributed in an [Formula: see text]-implanted Fe film. They were found to move in opposite directions along straight trajectories parallel to the stripes axis, when driven by a moderate dc magnetic field. Using the approximate Thiele equation, analytical expressions for the forces acting on such magnetic defects and a microscopic explanation for the direction of their motion could be obtained. Straight trajectories are related to the presence of a periodic stripe domain pattern, which imposes the gyrotropic force to vanish even if a nonzero, half-integer topological charge is carried by the defects in some layers across the film thickness.

6.
Bone Marrow Transplant ; 40(8): 735-9, 2007 Oct.
Article in English | MEDLINE | ID: mdl-17700603

ABSTRACT

We verified the feasibility of a multi-cycle peripheral blood progenitor cell (PBPC)-supported high-dose chemotherapy (HDC) regimen in patients with non-small cell lung cancer (NSCLC). The HDC regimen consisted of a single course of high-dose epirubicin given in combination with cisplatin plus filgrastim, followed by three courses of high doses of carboplatin and paclitaxel with PBPC reinfusion and filgrastim. Of the 16 enrolled patients, 13 provided an adequate number of PBPCs by a single leukapheresis, while in the three needed two procedures, with a median number of CD34+, CD34+/CD33- and CD34+/CD38- cells collected per patient was 13.5 x 10(6), 10.9 x 10(6) and 0.9 x 10(6)/kg, respectively. No toxic death occurred, and the collected PBPCs supported a rapid hematopoietic reconstitution after HDC; however, seven patients early interrupted the treatment early due to early progressive disease (n=4) or prolonged grade 3 peripheral neurotoxicity (n=3). Despite an overall response rate of 42%, the median survival for stage IV patients has been 5 months (range: 1-25+). Of two patients with stage IIIB NSCLC, one is continuously disease-free at 71+ months, while of 14 with stage IV disease, one is currently alive with disease at 25+ months. In conclusion, the combination of high-dose epirubicin with cisplatin plus filgrastim is an effective regimen in releasing large amounts of PBPCs, which can then be safely employed to support multiple courses of HDC. Multiple cycles of PBPC-supported high-dose carboplatin and paclitaxel are ineffective in treating patients with advanced NSCLC.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Carcinoma, Non-Small-Cell Lung/drug therapy , Cisplatin/administration & dosage , Lung Neoplasms/drug therapy , Peripheral Blood Stem Cell Transplantation , Adult , Carboplatin/administration & dosage , Combined Modality Therapy , Epirubicin/administration & dosage , Female , Filgrastim , Granulocyte Colony-Stimulating Factor/administration & dosage , Humans , Leukapheresis , Middle Aged , Paclitaxel/administration & dosage , Pilot Projects , Recombinant Proteins
7.
Bone Marrow Transplant ; 40(11): 1045-8, 2007 Dec.
Article in English | MEDLINE | ID: mdl-17922037

ABSTRACT

We report the experience of the EBMT Solid Tumours Working Party (STWP) using high-dose chemotherapy (HDCT) with PBPC support in patients with non-small cell lung cancer (NSCLC). Between 1989 and 2004, 36 NSCLC patients (27 men and 9 women), median age 53.5 years (range: 24-62) were treated with 63 HDCT courses. A high-dose carboplatin-based regimen was used in 53% of the cases. Thirty-two patients had relapsed/metastatic disease, while four classified as stage IIIB received HDCT followed by radiotherapy. No treatment-related death occurred. Of 25 patients who were planned to receive multi-cycle HDCT, 4 cases (16%) interrupted the treatment early due to prolonged severe toxicities and 4 (16%) due to progressive disease. Of 36 evaluable patients, 3 (8%) achieved a complete remission and 13 (36%) had a partial remission at an overall response rate of 44%. Of these, one patient with stage IIIB and one with stage IV are alive disease free at 71+ and 149+ months, respectively. After a median follow-up of 48 months (range: 6-149), median survival was 7 months (range: 1-149). Despite one anecdotal case, HDCT did not show significant activity, but induced relevant morbidity in NSCLC patients.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carboplatin/administration & dosage , Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/drug therapy , Adult , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carboplatin/adverse effects , Combined Modality Therapy/adverse effects , Dose-Response Relationship, Drug , Europe , Female , Humans , Male , Middle Aged , Peripheral Blood Stem Cell Transplantation/adverse effects , Registries , Remission Induction , Retrospective Studies , Survival Analysis
8.
J Exp Clin Cancer Res ; 26(1): 141-3, 2007 Mar.
Article in English | MEDLINE | ID: mdl-17550143

ABSTRACT

Intraocular metastases, especially to the retina, are uncommon in cancer patients and generally occur in an advanced phase of the disease. In patients with lung cancer, uveal metastases, in particular to the choroid, are the most frequent, and are associated mainly with small cell carcinoma or undifferentiated carcinoma. We report a case of unilateral retinal detachment as first sign of a moderately differentiated lung adenocarcinoma in a 55-year-old non-smoker that was admitted to the hospital for the first time complaining of a sudden visual loss in the superior fields of the left eye. A CT revealed a slight retinal enlargement of the left eye and a solid mass of about 3 centimeters behind the right pulmonary hilus. Bronchoscopic biopsies were performed with diagnosis of adenocarcinoma of the lung. The patient died after 2 months for rapid progression of the disease despite of combined chemotherapy treatment.


Subject(s)
Adenocarcinoma/secondary , Bone Neoplasms/secondary , Lung Neoplasms/diagnosis , Retinal Detachment/etiology , Retinal Neoplasms/secondary , Adenocarcinoma/complications , Adenocarcinoma/diagnosis , Adenocarcinoma/pathology , Bone Neoplasms/diagnosis , Bone Neoplasms/pathology , Cell Differentiation , Fatal Outcome , Humans , Lung Neoplasms/pathology , Male , Middle Aged , Retinal Detachment/pathology , Retinal Neoplasms/complications , Retinal Neoplasms/diagnosis , Retinal Neoplasms/pathology , Tomography, X-Ray Computed
9.
J Phys Condens Matter ; 29(46): 465803, 2017 11 22.
Article in English | MEDLINE | ID: mdl-29067917

ABSTRACT

The resonant eigenmodes of an α'-FeN thin film characterized by weak stripe domains are investigated by Brillouin light scattering and broadband ferromagnetic resonance experiments, assisted by micromagnetic simulations. The spectrum of the dynamic eigenmodes in the presence of the weak stripes is very rich and two different families of modes can be selectively detected using different techniques or different experimental configurations. Attention is paid to the evolution of the mode frequencies and spatial profiles under the application of an external magnetic field, of variable intensity, in the direction parallel or transverse to the stripes. The different evolution of the modes with the external magnetic field is accompanied by a distinctive spatial localization in specific regions, such as the closure domains at the surface of the stripes and the bulk domains localized in the inner part of the stripes. The complementarity of BLS and FMR techniques, based on different selection rules, is found to be a fruitful tool for the study of the wealth of localized magnetic excitations generally found in nanostructures.

10.
J Phys Condens Matter ; 29(5): 055001, 2017 Feb 08.
Article in English | MEDLINE | ID: mdl-27911881

ABSTRACT

Investigations of the complex behavior of the magnetization of manganese arsenide thin films due to defects induced by irradiation of slow heavy ions are presented. In addition to the thermal hysteresis suppression already highlighted in Trassinelli et al (2014 Appl. Phys. Lett. 104 081906), we report here on new local magnetic features recorded by a magnetic force microscope at different temperatures close to the characteristic sample phase transition. Complementary measurements of the global magnetization in different conditions (applied magnetic field and temperatures) enable the film characterization to be completed. The obtained results suggest that the ion bombardment produces regions where the local mechanical constraints are significantly different from the average, promoting the local presence of magneto-structural phases far from the equilibrium. These regions could be responsible for the thermal hysteresis suppression previously reported, irradiation-induced defects acting as seeds in the phase transition.

11.
Ann Oncol ; 17 Suppl 5: v103-5, 2006 May.
Article in English | MEDLINE | ID: mdl-16807435

ABSTRACT

Malignant Pleural Mesothelioma (MPM) continues to be a challenging problem; because few patients may be treated with radical surgery and conventional chemotherapy have achieved very dismal results. Pemetrexed is a new drug with multitarget antifolate activity which seems to be particularly active in many solid tumors and also in MPM. The principal clinical experiences of pemetrexed alone or in combination with other compounds, chiefly platinum and its derivative, are reported. The Italian study on 1114 cases of MPM treated over 30 months is discussed and the definitive results will be available after a complete external review of all responsive patients.


Subject(s)
Antimetabolites, Antineoplastic/therapeutic use , Glutamates/therapeutic use , Guanine/analogs & derivatives , Mesothelioma/drug therapy , Pleural Neoplasms/drug therapy , Antimetabolites, Antineoplastic/adverse effects , Clinical Trials as Topic , Glutamates/adverse effects , Guanine/adverse effects , Guanine/therapeutic use , Humans , Italy , Pemetrexed
12.
Bone Marrow Transplant ; 38(6): 407-12, 2006 Sep.
Article in English | MEDLINE | ID: mdl-16951690

ABSTRACT

We conducted a prospective randomized clinical trial to assess the mobilizing efficacy of filgrastim, lenograstim and molgramostim following a disease-specific chemotherapy regimen. Mobilization consisted of high-dose cyclophosphamide in 45 cases (44%), and cisplatin/ifosfamide/etoposide or vinblastine in 22 (21%), followed by randomization to either filgrastim or lenograstim or molgramostim at 5 microg/kg/day. One hundred and three patients were randomized, and 82 (79%) performed apheresis. Forty-four (43%) patients were chemonaive, whereas 59 (57%) were pretreated. A median number of one apheresis per patient (range, 1-3) was performed. The median number of CD34+ cells obtained after mobilization was 8.4 x 10(6)/kg in the filgrastim arm versus 5.8 x 10(6)/kg in the lenograstim arm versus 4.0 x 10(6)/kg in the molgramostim arm (P=0.1). A statistically significant difference was observed for the median number of days of growth factor administration in favor of lenograstim (12 days) versus filgrastim (13 days) and molgramostim (14 days) (P<0.0001) and for the subgroup of chemonaive patients (12 days) versus pretreated patients (14 days) (P<0.001). In conclusion, all three growth factors were efficacious in mobilizing peripheral blood progenitor cells with no statistically significant difference between CD34+ cell yield and the different regimens, and the time to apheresis is likely confounded by the different mobilization regimens.


Subject(s)
Adjuvants, Immunologic/administration & dosage , Antineoplastic Agents/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Granulocyte Colony-Stimulating Factor/administration & dosage , Granulocyte-Macrophage Colony-Stimulating Factor/administration & dosage , Hematopoietic Stem Cell Mobilization , Neoplasms/therapy , Peripheral Blood Stem Cell Transplantation , Adolescent , Adult , Cisplatin/administration & dosage , Cyclophosphamide/administration & dosage , Etoposide/administration & dosage , Female , Filgrastim , Humans , Ifosfamide/administration & dosage , Lenograstim , Male , Middle Aged , Recombinant Proteins/administration & dosage , Time Factors , Transplantation, Autologous , Vinblastine/administration & dosage
13.
Cancer Res ; 48(21): 6193-200, 1988 Nov 01.
Article in English | MEDLINE | ID: mdl-3167866

ABSTRACT

The cytotoxic effect of the combination of N-methylformamide (NMF) with 5-fluorouracil (5-FU) on cell survival of the human colon cancer line HT29 was assessed. The differentiating activity of NMF was evidenced by morphological maturation and conversion of cell culture characteristics to those consistent with a more benign phenotype. In combination experiments, the noncytotoxic concentration of 1% NMF was chosen and doses of 5-FU ranging from 5 to 25 micrograms/ml were employed. Two main schedules were tested either on exponentially or stationarily growing cells: (a) 1% NMF for 72 h followed by 12-h exposure to 5-FU; (b) 5-FU for 12 h followed by 72-h exposure to 1% NMF. The results obtained demonstrated that the 5-FU----NMF sequence determined a powerful reduction in the surviving fraction of HT29 cells, while the reverse sequence did not increase the killing effect of 5-FU given alone. Immunocytochemical and scanning electron microscopy studies seemed to confirm that the association in which the differentiating agent followed the 5-FU treatment strongly impaired cellular integrity and function and that cytoskeletal elements, particularly microfilaments, and surface structures could play an essential role in the mechanisms of cytotoxicity. Furthermore, the results of this work indicate that drug sequence is a critical factor for the optimal combination of 5-FU and NMF.


Subject(s)
Adenocarcinoma/pathology , Antineoplastic Combined Chemotherapy Protocols/pharmacology , Colonic Neoplasms/pathology , Fluorouracil/administration & dosage , Formamides/administration & dosage , Adenocarcinoma/drug therapy , Cell Survival/drug effects , Colonic Neoplasms/drug therapy , Cytoskeleton/drug effects , Formamides/pharmacology , Humans , Tumor Cells, Cultured/drug effects
14.
J Phys Condens Matter ; 28(13): 136001, 2016 Apr 06.
Article in English | MEDLINE | ID: mdl-26941191

ABSTRACT

In this work, we study magnetic thin films presenting magnetic stripe patterns. A fingerprint of such domains is a linear behavior of the in-plane magnetization curves below a given saturation field. We present free energy models for the in-plane magnetization curves which permit us to extract key geometrical information about the stripe patterns, such as the maximum canted angle of the magnetization and the domain wall width. As an example, we discuss in this work magnetization curves for Fe(1-x)Ga(x) magnetic films which present a stripe pattern with a period of 160 nm and we found a typical maximum canted angle of 85° and a domain wall width around 30 nm.

15.
J Clin Oncol ; 9(4): 675-8, 1991 Apr.
Article in English | MEDLINE | ID: mdl-1829757

ABSTRACT

Ondansetron (OND) is a new 5-HT3 receptor antagonist that give complete protection from emesis/nausea in approximately 50% of cisplatin (CDDP)-treated patients. To evaluate if dexamethasone (DEX) added to OND increases antiemetic efficacy, we carried out a double-blind randomized crossover study to compare the antiemetic activity of OND with OND plus DEX. One hundred two chemotherapy-naive patients (44 women and 58 men) scheduled to receive CDDP chemotherapy at doses greater than or equal to 50 mg/m2 entered the study. Eighty-nine patients completed both cycles with the following results: complete protection from emesis/nausea was obtained in 57/59 patients (64.0%/66.3%) with OND and in 81/79 (91.0%/88.8%) with OND plus DEX (P = .0005/P = .0021). At the end of the study, 53% of the patients expressed a treatment preference, and of these, 74% chose OND plus DEX compared with 26% who preferred OND alone, a statistically significant difference (P less than .003). Side effects were very mild and not significantly different between the two treatments. We conclude that OND plus DEX is more efficacious than OND in protecting patients from CDDP-induced emesis and nausea.


Subject(s)
Antiemetics/therapeutic use , Cisplatin/adverse effects , Dexamethasone/therapeutic use , Imidazoles/therapeutic use , Serotonin Antagonists , Vomiting/prevention & control , Double-Blind Method , Drug Therapy, Combination , Female , Humans , Linear Models , Male , Middle Aged , Nausea/chemically induced , Nausea/prevention & control , Ondansetron , Vomiting/chemically induced
16.
J Clin Oncol ; 17(11): 3531-9, 1999 Nov.
Article in English | MEDLINE | ID: mdl-10550151

ABSTRACT

PURPOSE: To determine the feasibility and safety of multiple sequential courses of high-dose chemotherapy and peripheral-blood progenitor cells (PBPCs) administered in a multicenter setting to patients with small-cell lung cancer. PATIENTS AND METHODS: Sixty-nine patients (limited disease, n = 30; extensive disease, n = 39) treated at 15 European centers were scheduled to receive three courses of high-dose chemotherapy with ifosfamide 10 g/m(2), carboplatin 1200 mg/m(2), and etoposide 1200 mg/m(2) (ICE) divided over 4 days at 28-day intervals. PBPCs were harvested before treatment and mobilized with epirubicin 150 mg/m(2) administered via an intravenous bolus divided over 2 days and filgrastim 5 microg/kg/d administered subcutaneously. RESULTS: The performed leukaphereses (one to five per patient) yielded a median of 16.6 x 10(6)/kg (range, 1.0 to 96.6 x 10(6)/kg) CD34(+) cells, which was sufficient for three reinfusions. Fifty patients (72%) completed the treatment according to schedule. Nine patients completed two courses, and six patients completed one course of treatment. The increase in dose-intensity was 290% that of a standard ICE regimen. The median duration of myelosuppression was similar between courses, namely 4 days (range, 1 to 12 days) for leukocytes less than 0.5 x 10(9)/L and 4 days (range, 0 to 22 days) for thrombocytes less than 20 x 10(9)/L. Febrile neutropenia developed in 66% of courses, severe diarrhea in 14%, mucositis in 10%, and nausea and vomiting in 21% of courses. There were six cases of toxic death (9%), most of which occurred in the first year of accrual and thus were attributable to the learning curve. The antitumor effect of the regimen was reflected in an 86% remission rate (95% confidence interval [CI], 74% to 93%), with 51% of patients achieving a complete response (95% CI, 38% to 63%). Median overall survival was 18 months for patients with limited disease and 11 months for patients with extensive disease. CONCLUSION: This multiple sequential high-dose ICE regimen could be safely administered on a multicenter basis to patients with small-cell lung cancer. The dose-intensity could be increased to 290% that of standard ICE regimen. The benefit of this approach is currently being tested in a randomized trial that aims to double the long-term rate of survival for patients with small-cell lung cancer.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Small Cell/drug therapy , Granulocyte Colony-Stimulating Factor/therapeutic use , Hematopoietic Stem Cells/metabolism , Lung Neoplasms/drug therapy , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carcinoma, Small Cell/pathology , Cisplatin/administration & dosage , Cisplatin/adverse effects , Dose-Response Relationship, Drug , Etoposide/administration & dosage , Etoposide/adverse effects , Europe , Feasibility Studies , Female , Filgrastim , Humans , Ifosfamide/administration & dosage , Ifosfamide/adverse effects , Logistic Models , Lung Neoplasms/pathology , Male , Middle Aged , Neoplasm Metastasis , Recombinant Proteins
17.
J Clin Oncol ; 18(17): 3125-34, 2000 Sep.
Article in English | MEDLINE | ID: mdl-10963641

ABSTRACT

PURPOSE: According to one of the most recent key scientific questions concerning the use of biomarkers in clinical trials, we investigated whether node-negative breast cancer patients, defined as high-risk cases on the basis of tumor cell proliferation, could benefit from cyclophosphamide, methotrexate, and fluorouracil (CMF) adjuvant therapy. PATIENTS AND METHODS: Two hundred eighty-one patients with negative nodes and rapidly proliferating tumors, defined according to thymidine labeling index (TLI), were randomized to receive six cycles of CMF or no further treatment after surgery +/- radiotherapy. RESULTS: The 5-year disease-free survival (DFS) was 83% for patients treated with CMF compared with 72% in the control group (P: =.028). Adjuvant treatment reduced both locoregional and distant metastases. When clinical outcome was analyzed in cell kinetic subgroups characterized according to tertile criteria, compared with patients in the control arm, 5-year DFS was significantly higher after adjuvant CMF in patients with TLI values in the second (78% v 88%, respectively; P: =.037) and third tertiles (58% v 78%, respectively; P: =.024). CONCLUSION: The results from this randomized clinical study indicate that patients with node-negative, rapidly proliferating tumors significantly benefit from adjuvant CMF.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Breast Neoplasms/pathology , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Breast Neoplasms/surgery , Cell Division/physiology , Chemotherapy, Adjuvant , Cyclophosphamide/administration & dosage , Cyclophosphamide/adverse effects , Disease-Free Survival , Female , Fluorouracil/administration & dosage , Fluorouracil/adverse effects , Humans , Lymph Nodes/pathology , Lymphatic Metastasis , Methotrexate/administration & dosage , Methotrexate/adverse effects , Middle Aged , Patient Compliance , Prospective Studies , Risk Factors
18.
J Clin Oncol ; 15(1): 297-303, 1997 Jan.
Article in English | MEDLINE | ID: mdl-8996156

ABSTRACT

PURPOSE: The nucleoside analog, gemcitabine, has shown activity as a single agent in the treatment of metastatic non-small-cell lung cancer (NSCLC). Its combination with cisplatin in preclinical models suggested synergy between the two drugs. The aim of the study was to evaluate the clinical efficacy and toxicity of the cisplatin-gemcitabine combination in advanced NSCLC. PATIENTS AND METHODS: Forty-eight consecutive previously untreated NSCLC patients entered the trial from January to June 1994. The median age was 60 years (range, 37 to 70) and performance status (PS) was 0 or 1; 22 patients had unresectable stage III disease (21 stage IIIB and one stage IIIA) and 26 had stage IV disease. Gemcitabine 1 g/m2 was administered weekly (days 1, 8, and 15) followed by a 1-week rest and cisplatin 100 mg/m2 on day 2 of each 28-day cycle. Survival and response were determined in accordance with the intention-to-treat principle in all enrolled patients. RESULTS: Of 48 assessable patients, one (stage IV) had a complete response (CR) and 25 achieved a partial response (PR). The overall response rate was 54% (95% confidence interval [CI], 40% to 68%). Thrombocytopenia was the main side effect, with 52% of patients experiencing grade III to IV toxicity, which was usually short-lived and responsible for the omission of gemcitabine administration on day 15 in 50% of chemotherapy courses. The median survival time was 61.5 weeks (95% CI, 40 to 71). CONCLUSION: The combination of gemcitabine and cisplatin induced a high response rate in both stage IIIB and IV NSCLC, with modest side effects. The regimen deserves further careful evaluation in a phase III prospective randomized trial.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/drug therapy , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carcinoma, Non-Small-Cell Lung/pathology , Cisplatin/administration & dosage , Cisplatin/adverse effects , Deoxycytidine/administration & dosage , Deoxycytidine/adverse effects , Deoxycytidine/analogs & derivatives , Drug Administration Schedule , Female , Humans , Lung Neoplasms/pathology , Male , Middle Aged , Neoplasm Staging , Neutropenia/chemically induced , Prospective Studies , Gemcitabine
19.
J Clin Oncol ; 17(11): 3522-30, 1999 Nov.
Article in English | MEDLINE | ID: mdl-10550150

ABSTRACT

PURPOSE: To compare gemcitabine and cisplatin (GC) with mitomycin, ifosfamide, and cisplatin (MIC) chemotherapy in patients with stage IIIB (limited to T4 for pleural effusion and N3 for supraclavicular lymph nodes) or stage IV non-small-cell lung cancer (NSCLC). The end points were the evaluation of quality of life (QoL), response rates, survival, and toxicity. PATIENTS AND METHODS: Three hundred seven patients were randomized to receive either gemcitabine 1,000 mg/m(2) on days 1, 8, and 15 plus cisplatin 100 mg/m(2) on day 2, every 28 days, or mitomycin 6 mg/m(2), ifosfamide 3,000 mg/m(2), and mesna on day 1 plus cisplatin 100 mg/m(2) on day 2, every 28 days. The whole-blood cell count was repeated on day 1 in both arms and weekly in the GC arm before each gemcitabine administration. RESULTS: No major differences in changes in QoL were observed between the two treatment arms. The objective response rate was 38% in the GC arm compared with 26% in the MIC arm (P =.029). The median survival time was 8.6 months in the GC arm and 9.6 months in the MIC arm (P =.877, log-rank test). Grade 3 and 4 thrombocytopenia was significantly worse in the GC arm (64% v 28%, P <.001), whereas grade 3 and 4 alopecia was reported more commonly in the MIC arm (39% v 12%, P <. 001). CONCLUSION: We report an increased response rate without changes in QoL and a similar overall survival, time to progression, and time to treatment failure for the GC when compared with the MIC regimen in the treatment of advanced NSCLC.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/drug therapy , Adult , Aged , Antimetabolites, Antineoplastic/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carcinoma, Non-Small-Cell Lung/mortality , Carcinoma, Non-Small-Cell Lung/pathology , Cisplatin/administration & dosage , Cisplatin/adverse effects , Deoxycytidine/administration & dosage , Deoxycytidine/adverse effects , Deoxycytidine/analogs & derivatives , Dose-Response Relationship, Drug , Female , Humans , Ifosfamide/administration & dosage , Ifosfamide/adverse effects , Italy , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Male , Middle Aged , Mitomycin/administration & dosage , Mitomycin/adverse effects , Quality of Life , Sample Size , Survival Rate , Gemcitabine
20.
J Clin Oncol ; 20(21): 4285-91, 2002 Nov 01.
Article in English | MEDLINE | ID: mdl-12409326

ABSTRACT

PURPOSE: To evaluate whether two commonly used newer platinum-based regimens offer any advantage over vinorelbine-cisplatin (reference regimen) in response rate for patients with advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Chemotherapy-naive patients were randomized to receive gemcitabine 1,250 mg/m(2) days 1 and 8 plus cisplatin 75 mg/m(2) day 2 every 21 days (GC arm), or paclitaxel 225 mg/m(2) (3-hour infusion) then carboplatin (area under the concentration-time curve of 6 mg/mL x min), both on day 1 every 21 days (PCb arm), or vinorelbine 25 mg/m(2)/wk for 12 weeks then every other week plus cisplatin 100 mg/m(2) day 1 every 28 days (VC arm). RESULTS: Six hundred twelve patients were randomized to treatment (205 GC, 204 PCb, and 203 VC). Overall response rates for the GC (30%) and PCb (32%) arms were not significantly different from that of the VC arm (30%). There were no differences in overall survival, time to disease progression, or time to treatment failure. Median survival for the GC, PCb, and VC groups was 9.8, 9.9, and 9.5 months, respectively. Neutropenia was significantly higher on the VC arm (GC 17% or PCb 35% v VC 43% of cycles, P <.001), as was thrombocytopenia on the GC arm (GC 16% v VC 0.1% of cycles, P <.001). Alopecia and peripheral neurotoxicity were most common on the PCb arm, as was nausea/vomiting on the VC arm (P <.05). CONCLUSION: Efficacy end points were not significantly different between experimental and reference arms, although toxicities showed differences. These findings suggest that chemotherapy in NSCLC has reached a therapeutic plateau.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Deoxycytidine/analogs & derivatives , Lung Neoplasms/drug therapy , Vinblastine/analogs & derivatives , Adult , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carboplatin/administration & dosage , Carcinoma, Non-Small-Cell Lung/pathology , Cisplatin/administration & dosage , Deoxycytidine/administration & dosage , Disease Progression , Female , Humans , Infusions, Intravenous , Lung Neoplasms/pathology , Male , Middle Aged , Neutropenia/chemically induced , Paclitaxel/administration & dosage , Survival Analysis , Thrombocytopenia/chemically induced , Treatment Outcome , Vinblastine/administration & dosage , Vinorelbine , Gemcitabine
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