No abstract available.
Drug Therapy, Combination* ; Epirubicin* ; Fluorouracil*

PURPOSE: To evaluate the direct anti-cancer effect of a single instillation of epirubicin (SIE) after transurethral resection of bladder tumor (TURBT) for non-muscle-invasive bladder cancer (NMIBC) by analysis of immediate urine cytology (IUC). MATERIALS AND METHODS: We reviewed the records of 158 patients who had IUC after TURBT for NMIBC. Fifty-six patients were treated with SIE after TURBT and 102 patients were not treated with SIE. The direct anti-cancer effect of SIE was compared in the two groups according to the result of IUC. The relationship between SIE and IUC in NMIBC was analyzed by use of multivariate Cox proportional hazards regression models. RESULTS: The IUC-positive rate was 33.9% in the SIE group and 42.1% in the non-SIE group (p=0.005). The IUC-positive rate was lower in the SIE group than in the non-SIE group for each factor, including tumor stage, tumor grade, tumor size, tumor multiplicity, and preoperative urine cytology. Multivariate Cox proportional hazards regression analysis revealed that SIE was significantly associated with a negative IUC result in patients with NMIBC (HR, 0.163) (p<0.001). CONCLUSIONS: These results indicate the direct anti-cancer effect of SIE in patients who undergo TURBT for NMIBC.
Epirubicin ; Humans ; Urinary Bladder ; Urinary Bladder Neoplasms

No abstract available.
Cell Line, Tumor* ; Doxorubicin* ; Epirubicin* ; Humans*

BACKGROUND: There has been a growing realization that a variety of anticancer drugs can induce apoptotic cell death. In the present study, an attempt was made to investigate the responsiveness of gastric cancer cells to various anticancer drugs and to identify which apoptosis-related proteins could be correlated to chemosensitivity. METHODS: Nine human Korean gastric cancer cell lines (SNU-1, -5, -16, -484, -601, -620, -638, -668, and -719) were analyzed. The cytotoxicity of each cell line to camptothecin, cisplatin, mitomycin C, vincristine, 5-FU, epirubicin, and doxorubicin was determined by using a MTT (dimethylthiazole- diphenyltetrazolium-bromide) assay. Apoptosis-related proteins (p53, p21, Bcl-2, Bcl-x, and Bax) were detected using a Western blot assay. RESULTS: Of the nine gastric cancer cell lines, SNU-1 was resistant while SNU-5 was sensitive to anticancer drugs. Mutated p53 was detected in all the cell lines. The highest expression of Bcl-2 was observed in SNU-1 while less or no expression of Bcl-2 was observed in SNU-5, -484, and -601. Bcl-xL was less expressed in SNU-5 than in the other cell lines. CONCLUSIONS: Chemosensitivity in gastric cancer cell lines was correlated mainly with the level of Bcl-2 and partly with that of Bcl-xL. There was no correlation between the chemosensitivity and other apoptosis-related proteins, such as p21, p53, Bax, and Bcl-xS in the studied gastric cancer cell lines.
Blotting, Western ; Camptothecin ; Cell Death ; Cell Line* ; Cisplatin ; Doxorubicin ; Epirubicin ; Fluorouracil ; Humans ; Mitomycin ; Stomach Neoplasms* ; Vincristine

To study the impact of single instillation of epirubicin (SIE) on the cancer recurrence of non-muscle invasive bladder cancer (NMIBC) after transurethral resection of bladder tumor (TURBT) in Korean patients. The major inclusion criteria were NMIBC patients. The major exclusion criteria were muscle invasive bladder cancer, metastatic bladder cancer, combined urinary upper tract tumor, and carcinoma in situ. SIE group received 50 mg epirubicin within 6 hours after TURBT. Non-SIE group did not receive epirubicin. This study enrolled a total of 214 patients diagnosed as having NMIBC during the period from October 2003 through January 2010 at the single institutions. Follow-up of the patients was conducted through January 2012. The median age of patients was 63.4 years. Of 112 evaluable patients in the SIE group, cancer recurrence rate was 33.9% and in non-SIE group, cancer recurrence rate was 62.7% (p<0.001). The recurrence-free survival duration was longer in Group SIE compared with Group non-SIE (p<0.001). Multivariate analysis revealed that SIE was significantly associated with cancer recurrence (HR 0.213, p<0.001). We confirmed the impact of SIE on the cancer recurrence in the Korean patients who underwent TURBT for NMIBC. Single instillation of chemo-agent after TUR-B might be recommended in Korean patients for reduce bladder cancer recurrence and provide longer recurrence-free survival duration.
Carcinoma in Situ ; Epirubicin* ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: In attempt to provide a feasible chemotherapeutic regimen for advanced gastric cancer patients, the combination of cisplatin, epirubicin, leucovorin and fluorouracil (PELF) has been developed. A trial was performed to confirm the clinical activity, in terms of response rate and toxicity and duration of survival, of the PELF combination chemotherapy. MATERIALS AND METHODS: From April 1995 to July 1997, patients with measurable unresectable and/or metastatic gastric cancer received PELF combination chemotherapy. The regimen consisted of cisplatin 40 mg/m2 IV on days 1 and 5; epirubicin 30 mg/m2 IV on days 1 and 5; 5-fluorouracil 300 mg/m2 and leucovorin 20 mg/m2 IV on days 1 through 4. The cycle was repeated every 3 weeks. RESULT: Among 21 evaluable patients, 1 patient achieved complete response (5.3%) and 8 patients, partial response (42.1%). The median survival of overall patients was 36 weeks, the median time to progression of 21 evaluable patients was 27 weeks. There was severe myelosuppression; leucopenia 73.1%, WHO grade 3~4 11.5% of cycles. Non-hematologic toxicities were also severe nausea or vomiting in 100% of patients, grade 3~4 13.0% of patients, alopecia in 91.3% of patients, grade 3~4 52.2% of patients. CONCLUSION: This study showed that the PELF combination is effective in overall response rates. However, it is not recommended for routine clinical use because of its toxicities. Further phase III study will be warranted.
Alopecia ; Cisplatin ; Drug Therapy, Combination* ; Epirubicin ; Etoposide* ; Fluorouracil* ; Humans ; Leucovorin* ; Nausea ; Stomach Neoplasms* ; Vomiting

PURPOSE: The aim of this study was to determine whether the ERCC1 expression is effective to predict the clinical outcomes of patients with advanced gastric cancer (AGC) and who were treated with cisplatin-based first-line chemotherapy. MATERIALS AND METHODS: A total of 89 measurable AGC patients received cisplatin and capecitabine, with or without epirubicin, as a part of a randomized phase II study. Patients were included for the current molecular analysis if they had received two or more cycles of chemotherapy, their objective tumor responses were measured and if their paraffin-embedded tumor samples were available. The ERCC1 expression was examined by performing immunohistochemical (IHC) staining, and the patients were divided into two groups (positive or negative) according to the presence of IHC staining of the tumor cell nuclei. RESULTS: Of the 32 eligible patients, 21 patients (66%) had tumor with a positive expression of ERCC1 and the remaining 11 patients had tumor with a negative ERCC1-expression. The ERCC1-negative patients achieved a higher response rate than that of the ERCC1-positive patients (44% vs. 28%, respectively), although the difference was not statistically significant (p=0.42). The median survival time for the all patients was 14.6 months (95% CI: 13.6 to 15.6 months). The one-year survival rate was similar for the ERCC1-negative patients (61%) and the ERCC1-positive patients (70%). CONCLUSION: In the current study, the tumor ERCC1 expression by IHC staining could not predict the clinical response or survival of AGC patients who were treated with cisplatin-based first-line chemotherapy. The ERCC1 protein expression does not appear to be a useful tool for the selection of tailored chemotherapy for these patients.
Cell Nucleus ; Cisplatin ; Deoxycytidine ; Epirubicin ; Fluorouracil ; Humans ; Stomach Neoplasms ; Survival Rate ; Capecitabine

PURPOSE: Tegafur, an oral prodrug of 5-fluorouracil (5-FU), has been used in the treatment of gastric cancers. UFT (tegafur + uracil) has been developed to enhance the efficacy of tegafur. This study was conducted to assess the pharmacokinetics (PK) of tegafur in gastric cancer patients given the ECU-E regimen (epirubicin, cisplatin, UFT-E, an enteric-coated formula of UFT). A preliminary evaluation of antitumor efficacy and toxicity of ECU-E regimen was also performed. MATERIALS AND METHODS: Of the 32 gastric cancer patients registered for the ECU-E regimen, 8 participated in the PK study. The plasma concentration of tegafur was determined using HPLC. RESULTS: Seven out of the 8 patients were evaluable for response after 2 cycles, and showed 3 partial responses, 1 stable disease and 3 progressive diseases. No major toxicities were observed. Plasma profiles of the tegafur after the first dose showed significant differences in the amount and rate of absorption, i.e., rapid absorption group vs. slow absorption group. The level of C(max) in the rapid absorption group was 1.8 fold higher, and the AUC(0-5h) 4 fold greater, than those in the slow absorption group, nonetheless, the steady state concentrations showed no significant difference. These data indicate that the different absorption rates may not affect the overall exposure to tegafur. The patients with low Cp(ss, peak) showed poor efficacy compared to those with high Cp(ss, peak), suggesting that the concentration of tegafur may be one of the pharmacodynamic determinants in patients administered with ECU-E. CONCLUSION: This study evaluated the pharmacokinetics of tegafur in gastric patients given the ECU-E regimen, and provides preliminary data on the relationship between the plasma tegafur level and the efficacy, which warrants further evaluation.
Absorption ; Chromatography, High Pressure Liquid ; Cisplatin* ; Epirubicin* ; Fluorouracil ; Humans ; Pharmacokinetics* ; Plasma ; Stomach Neoplasms* ; Tegafur* ; Uracil

PURPOSE: We compared the prophylatic effects and complications of intravesical instillation of the epirubicin and Bacillus Calmette-Guerin (BCG) in patients with stage T1 bladder cancer. MATERIALS AND METHODS: A total 87 patients with stage T1 bladder cancer were treated with transurethral resection (TUR) between January 1992 and April 1998. Of them, 51 patients received BCG (Connaught strain, 81mg), 16 patients received 50mg epirubicin and 20 patients underwent TUR alone. The patients were followed for 18-78 months (mean 40 months). Recurrence rates, progression rates, mean months to tumor recurrence, recurrence free survival rate using Kaplan-Meier curve and complications were compared among three groups. RESULTS: The overall recurrence rate was 27.5% in BCG group, 37.5% in epirubicin group and 65% in control group. Mean months to tumor recurrence and recurrence free survival rate showed that both drugs were superior to TUR alone. The incidence of complications was 94% in BCG group and 12.5% in epirubicin group. CONCLUSIONS: BCG and epirubicin were superior to TUR alone in the prophylaxis of recurrence in stage T1 bladder cancer. Although the prophylactic efficacy of BCG was a little higher than that of the epirubicin, the toxicity rate of epirubicin was much lower than that of BCG. Therefore, epirubicin may be regarded as an alternative treatment of the BCG, especially for the patients who cannot tolerate the side effects of BCG.
Administration, Intravesical ; Bacillus* ; Epirubicin* ; Humans ; Incidence ; Mycobacterium bovis ; Recurrence ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: Breast cancer ranks as the second most frequent cancer in women in Korea, and the rate is gradually increasing. Compared to European countries and USA., the Korean breast cancer occurs at a younger age (mean age: 47) than in western countries (mean age: 60). We suppose that there is some biological differences between Korean and western breast cancer. This study was designed to determine the target chemotherapy agents for use on individual patients and define target patients for chemotherapy during the post-op period. Additionally, we desired to acquire primary data for further proteomic analysis of patients. METHODS: Twenty-one patients with breast cancer were entered in this study. Tumor specimens were taken and informed consent was obtained for use of the samples in drug sensitivity testing. MTS[3-(4,5-dimethylthiazol-2-yl)-5- (3-carboxy methoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium, inner salt] assay was able to be preformed in 16 patients (success rate, 76.2 percent). We used four drugs including Adriamycin, Epirubicin, 5-FU, and Taxol. RESULTS: In the axillary lymph node negative group, 5-FU (56.62%) and Taxol (53.85%) were sensitive drugs. There were no sensitive drugs in the p53 over-expression group. In the wild p53 group, 5-FU was the only sensitive drug. 5-FU was sensitive in both the ER and PR positive groups. Taxol was sensitive in the c-erbB2 low expression group. CONCLUSION: We obtained the results for chemosensitivity of breast cancer of Korean women. 5-FU and Taxol were relatively sensitive drugs, however we believe further data should be collected and added to obtain complete chemosensitivity results.
Breast Neoplasms* ; Breast* ; Doxorubicin ; Drug Therapy ; Epirubicin ; Female ; Fluorouracil ; Humans* ; Informed Consent ; Korea ; Lymph Nodes ; Paclitaxel