Bleomycin Chemotherapy

1st Edition - January 28, 1985
Editors: Branimir Ivan Sikic, Marcel Rozencweig, Stephen K. Carter
Language: English
eBook ISBN:
9 7 8 - 1 - 4 8 3 2 - 6 5 0 2 - 5

Bleomycin Chemotherapy focuses on the clinical uses of bleomycin. Bleomycin, a group of glycopeptides isolated from Streptomyces verticillus, has a unique structure and mechanism… Read more

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Bleomycin Chemotherapy focuses on the clinical uses of bleomycin. Bleomycin, a group of glycopeptides isolated from Streptomyces verticillus, has a unique structure and mechanism of action among anticancer drugs. The drug’s remarkable lack of bone marrow toxicity prompted its addition to myelosuppressive regimens and enabled treatment of patients with compromised hematopoietic function. Bleomycin is an integral component of one of the great triumphs of medical oncology—the curative treatment of metastatic testicular carcinomas. Similar curative potential has been demonstrated for bleomycin in combination with cisplatin and vinblastine in germ-cell cancers of the ovary. Bleomycin is included in several important treatment regimens for Hodgkin's disease and non-Hodgkin's lymphomas. The drug also has clinical activity against squamous carcinomas of various sites. These uses and other aspects, including the development of new bleomycin analogs, are discussed in the following chapters, which were first presented at a symposium jointly sponsored by the Northern California Cancer Program and Bristol Laboratories in San Francisco, California, 14-15 September 1984.

Contributors

Preface

I. Introduction

1. Bleomycin: More than a Decade Later

I. Introduction

II. Testicular Cancer

III. Hodgkin's Disease

IV. Non-Hodgkin's Lymphoma

V. Head and Neck Cancers

VI. Uterine Cervical Cancer

VII. Conclusion

References

2 Clinical Pharmacology of Bleomycin

I. Pharmaceutical Properties

II. Mechanism of Action

III. Pharmacokinetics

IV. Clinical Use

References

II. Testicular and Ovarian Cancers

3. Chemotherapy of Testicular Carcinoma: An Overview

I. Introduction

II. Chemotherapy

III. Prognostic Variables

IV. Toxicity

V. Conclusion

References

4. The Memorial Hospital Experience in the Management of Testicular Germ-Cell Tumors

I. Introduction

II. The VAB II Regimen

III. The VAB III Regimen

IV. VAB IV and VAB V Regimens

V. The VAB VI Regimen

VI. Adjuvant Surgery

VII. Conclusion

References

5. Effective Treatment of Malignant Ovarian Germ-Cell Tumors with Cisplatin, Vinblastine, and Bleomycin (PVB)

I. Introduction

II. Methods

III. Results

IV. Discussion

References

III. Head and Neck Cancer

6. The Role of Chemotherapy in the Treatment of Head and Neck Cancer

I. Introduction

II. Salvage Treatment

III. Primary Treatment

IV. Prognostic Factors

V. Conclusions

References

7. Head and Neck Cancer: Bleomycin plus Radiotherapy

I. Introduction

II. Randomized Studies

III. Nonrandomized Studies

IV. Normal Tissue Effects of Combined Treatment

V. Discussion

References

8. The Role of Induction Chemotherapy in Combined-Modality Treatment Programs

I. Introduction

II. Effect on Treatment and Survival

III. Testicular Cancer

IV. Osteosarcoma

V. Head and Neck Cancer

VI. Discussion

VII. Summary

References

9. Induction Chemotherapy in the Treatment of Head and Neck Cancer: SUNY Buffalo and VAMC Experience

I. Introduction

II. Methods

III. Results

IV. Discussion

V. Conclusion

References

IV. The Malignant Lymphomas

10. Hodgkin's Disease: an Overview and ABVD Studies in Milan

I. Introduction

II. MOPP versus ABVD

III. Salvage Treatment

IV. Cyclic MOPP/ABVD

V. Conclusion

References

11. Bleomycin in Combination with MOPP in the Management of Advanced Hodgkin's Disease: A Southwest Oncology Group Experience

I. Introduction

II. Patients and Methods

III. Results

IV. Discussion

References

12. Combined-Modality Studies in the Treatment of Hodgkin's Disease

I. Background

II. Prospective Clinical Trials

III. Combined-Modality Therapy in Pediatric Hodgkin's Disease

IV. Future Directions

References

13. The Non-Hodgkin's Lymphomas: an Overview

I. Low-Grade Lymphomas

II. Intermediate-Grade Lymphomas

III. High-Grade Lymphomas

IV. Future Directions

References

14. Non-Hodgkin's Lymphomas: Milan Studies

I. Introduction

II. Combined-Modality Therapy for Stage I to Stage II Disease

III. Alternating Chemotherapy in Stage III to Stage IV Disease

IV. Conclusion

Reference

15. BACOP and Related Studies in Non-Hodgkin's Lymphoma

I. Single-Agent Bleomycin

II. Bleomycin in Chemotherapy Combinations

III. Four- and Five-Drug Regimens

IV. Therapeutic Programs Using Continuous-Infusion Bleomycin

V. New Intensive-Treatment Multidrug Regimens

References

V. Non-Small-Cell Lung Cancer

16. A Reassessment of Bleomycin in Lung Cancer and Other Intrathoracic Neoplasms

I. Systemic Therapy of Lung Cancer

II. Locally Directed Therapy

III. Role in Treating Mesothelioma

IV. Future Directions

References

17. Non-Small-Cell Lung Cancer: Bleomycin plus Etoposide and Cisplatin

I. Introduction

II. Patients and Methods

III. Results

IV. Discussion

References

VI. Cervical Cancer

18. Cervical Cancer: Bleomycin Studies—An Overview

I. Introduction

II. Single-Agent Chemotherapy

III. Combination Chemotherapy Including Bleomycin

References

19. Bleomycin in Cervical Carcinoma: Protocols of the Northern California Oncology Group

I. Introduction

II. NCOG Protocol 5C81

III. NCOG Protocol 5C91

IV. Discussion

References

VII. Pulmonary Toxicity

20. Pulmonary Toxicity of Bleomycin

I. Incidence and Risk Factors

II. Clinical Features

III. Pathogenesis and Histopathology

IV. Clinical Management

V. Future Directions

References

VIII. Other Uses

21. Bleomycin: The Search for Other Indications

I. Single-Agent Activity of Bleomycin

II. Squamous-Cell Carcinomas

III. Primary Brain Tumors

IV. Superficial Bladder Tumors

V. Kaposi's Sarcoma

VI. Intracavitary Therapy

VII. Recommendations for Future Studies

VIII. Bleomycin in Combination Therapy

References

IX. New Bleomycins

22. Peplomycin and Tallysomycin S10b: Two Bleomycin Analogs

I. Introduction

II. Chemistry

III. Antitumor Screening Activity

IV. Mechanisms of Action

V. Preclinical Toxicology

VI. Pharmacology

VII. Clinical Studies

VIII. Conclusion

References

23. New Analogs and Derivatives of Bleomycin

I. Total Synthesis of Bleomycin and Preparation of Bleomycin Analogs

II. Preparation of New Bleomycins and Their Derivatives

III. Screening of Derivatives for Clinical Study

IV. Liblomycin

References

X. Summary and Prospects

24. Bleomycin: Future Prospects

I. Introduction

II. Combination Chemotherapy

III. Bleomycin and Radiotherapy

IV. Future Directions

V. Summary

References

25. Bleomycin in Chemotherapy: Summary and Closing Remarks

I. Chemistry

II. Pharmacokinetics

III. Toxicity

IV. Antitumor Activity

V. Future Considerations

VI. Summary

References