Liposomal doxorubicin for treatment of metastatic chemorefractory vulvar adenocarcinoma.
ABSTRACT Primaryadenocarcinoma of the vulva is a rare entity, and for widely metastatic vulvar adenocarcinoma, no effective treatment has been established.
A 65-year-old woman was diagnosed with regionally advanced vulvar adenocarcinoma, with bulky involvement of bilateral groin lymph nodes, and associated extramammary Paget's disease. Initial therapy consisted of multiagent chemotherapy and vulvar and groin irradiation, followed by radical vulvectomy with groin and pelvic lymph node dissection. She subsequently developed widely metastatic disease including brain, pulmonary, hepatic, osseus, and subcutaneous lesions. Treatment with liposomal doxorubicin (Doxil) resulted in dramatic regression of metastatic lesions and marked improvement in quality-of-life. She remains clinically well, greater than 1 year since initiating Doxil treatment for widely metastatic vulvar adenocarcinoma, and has surpassed 5 years of survival since her initial diagnosis.
We report the first case of Doxil used for the treatment of metastatic chemorefractory vulvar adenocarcinoma. We observed that Doxil was a well-tolerated and effective agent for this gynecologic malignancy, and warrants further investigation.
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ABSTRACT: A combination regimen of temozolomide (TMZ) and pegylated liposomal doxorubicin has been evaluated in the treatment of brain metastases from solid tumours. Nineteen consecutive patients (pts) have been enrolled in a prospective phase II trial and treated with TMZ 200 mg/m2 (days 1-5) and pegylated liposomal doxorubicin 35 mg/m2 (day 1) every 28 days. The study was prospectively projected according to the Simon's two-stage optimal design. Major toxicities have been grade III neutropenia and thrombocytopenia in one patient (pt) and grade III erythrodisesthesia in two pts. Three pts achieved a complete response (CR) and four a partial response (PR), for an overall response rate of 36.8% (95% CI: 19.1-59.2), which exceeded the target activity in the study design. A significant improvement in quality of life was demonstrated by FACT-G analysis. The median Progression Free Survival (PFS) was 5.5 (95% CI: 2.7-8.2) months while the median Overall Survival (OS) was 10.0 months (95% CI: 6.3-13.7). The TMZ/pegylated liposomal doxorubicin regimen was well tolerated with an encouraging activity in brain metastases from solid tumours.Cancer Chemotherapy and Pharmacology 02/2006; 57(1):34-9. · 2.80 Impact Factor
Dataset: Temozolamide 2006
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ABSTRACT: BACKGROUD: Perianal Paget's disease is a rare malignant condition affecting the epidermal apocrine gland that is usually complicated, with a confusing clinical picture, and diagnosis is therefore often delayed. Although, more than 100 years has gone by since its first description by Darier and Coulillaud in 1893, proper treatment guidelines have yet to be established. OBJECTIVE: To review the available literature, emphasizing various current treatment strategies and aiming to increase clinicians' awareness of this rare disease, along with its management, for better practice and improvement of patient prognosis. METHODS: The review of the concerned literature was done by searching and compiling data available on PubMed, Medline, and other databases using the key words "perianal Paget's disease," "extramammary Paget's disease," "intraepithelial adenocarcinoma," and "apocrine glands." CONCLUSIONS: Surgery is the mainstay of treatment. Some noninvasive therapeutic modalities were also reported to be effective, such as photodynamic therapy, imiquimod, radiotherapy, chemotherapy, anti-androgen therapy, and carbon dioxide. Management of perianal Paget's disease remains difficult, and large controlled, multicentric studies should be performed to compare the effectiveness of current thera-peutic modalities.Dermatologic Surgery 11/2012; · 1.87 Impact Factor