Yoav Horn

Phase I-II clinical trial with alpha-difluoromethylornithine ― an inhibitor of polyamine biosynthesis

Alpha-difluoromethylornithine (DFMO) is an enzyme-activated, irreversible inhibitor of ornithine decarboxylase, the first enzyme in the synthesis of the polyamines putrescine, spermidine and spermine. DFMO has been shown to have a cytostatic and cytotoxic effect against various human tumor cell lines. The present study was designed to evaluate the toxicity and efficacy of this compound when administered orally at a dose of 1.7 g/m sq. t.i.d. added to conventional chemotherapy to 38 patients with carcinoma of the breast, stomach, prostate, female genital organs or metastatic carcinoma of unknown origin. A control group of 32 patients with similar malignancies received conventional chemotherapy only. Gastrointestinal, hematologic and biochemical abnormalities caused by DFMO were negligible. Reasonable ototoxicity was the major toxic effect caused by DFMO and resulted in discontinuation of therapy in 6 of 38 patients (15.8%). No differences in disease progression were seen between those patients receiving DFMO plus conventional chemotherapy and those receiving only conventional chemotherapy.

The palliative efficacy of a single high dose of radiation in treatment of symptomatic osseous metastases

Radiation therapy is effective for palliation of painful metastatic osseous lesions. Various fractionation doses have been previously described. The present study was initiated to evaluate the efficacy of a high single dose of radiation on pain relief, with the goal of reducing the number of radiation sessions to a minimum. Treatment consisted of a high single dose of radiation ranging between 6 to 10 Gy administered to painful osseous metastases. Prior to radiation therapy response to conservative analgesic therapy was minimal in most cases. Response to radiation therapy thereafter was 71.3% lasting up to 6 and 12 months in 37.3% and 20.9% of cases respectively.

Intravesical Chemotherapy in a Controlled Trial with Thio-Tepa Versus Doxorubicin Hydrochloride

AbstractWe treated 25 patients with recurrent transitional cell carcinoma of the bladder with intravesical chemotherapy. The 2 drugs used were doxorubicin hydrochloride and thio-tepa introduced at 3-week intervals and checked for efficacy by repeated cystoscopy after every 3 instillations. The clinical data and results of both groups are presented, and the importance of intravesical treatment with minimal toxicity in this relatively benign condition is discussed.

Nutritional risk factors and breast cancer in Jewish and Arab women

Based on a lower reported incidence of breast cancer in the Arab population in Israel, nutritional levels were evaluated in a case-control study of 33 Jewish and 10 Arab patients with breast cancer all matched with a first-degree family-related control. Demographic, gynecologic, obstetric, anthropometric, genetically tumor-related, and nutritional data were ascertained through interviews, tests, and questionnaires. Food consumption, calories, protein, fat, and fiber intake, and anthropomorphic measures were calculated. The following results were obtained: 1. Calories of food consumption were significantly higher in Jewish and Arab patients than in their controls. 2. Jewish patients consumed significantly higher levels of monounsaturated fat; Arab patients consumed significantly higher levels of dietary fiber. 3. Animal protein intake was elevated in patients of both ethnic origins as compared with controls. 4. Vegetable fat and monounsaturated fatty acids were elevated in Arab patients as compared with Jewish patients. 5. Body weight of both Arab and Jewish patients was not significantly higher when compared with their controls. 6. Energy consumption and obesity were higher in breast cancer patients than in the controls. This supporting evidence suggests an association between obesity and breast cancer occurrence.

Nutritional Monitoring and Counselling for Cancer Patients during Chemotherapy

The objective of the study was to try to monitor the nutritional status of cancer patients during chemotherapeutic treatment. Concomitantly with chemotherapeutic treatment administered to patients with cancer of the gastrointestinal tract and metastatic carcinoma of unknown origin, levels of carotene, retinol, thiamine, riboflavin, pyridoxine, iron, total protein and hemoglobin were measured in the blood periodically. In addition, anthropometric studies were performed and the nutritional status was established. A total of 19 patients were subject for final evaluation. These patients formed 3 groups according to their nutritional status (good, medium, poor). The effect of chemotherapy was correlated to the nutritional status at 3 different periods of chemotherapy. Most patients with good clinical status maintained the initial nutritional status. Half of the patients with medium nutritional status improved clinically during therapy, and patients initially with poor nutritional status further deteriorated. The levels of most vitamins decreased to a certain degree during therapy and returned to initial values thereafter. Our impression is that cancer patients might benefit from intensive ongoing personal nutritional monitoring and counselling. The results presented have a preliminary meaning because of the small number of patients included in this study.

Breast cancer at medical centers in Israel, the West Bank, and the United States.

A comparison is made of the characteristics of female breast cancer patients, their diseases, and treatment practices in medical centers in Israel and the West Bank of the Jordan River. This experience is further compared with tumor registry data from a major medical center in the United States. Differences are found in the age distributions of patients, marital status, parity, stage of disease at diagnosis, delay between onset of symptoms and diagnosis as well as between diagnosis and treatment. Some of these observations reflect differences in population characteristics, sociocultural practices and local attitudes toward disease, its diagnosis and management.

Cancer Patterns at Medical Centers in Israel and the West Bank

This paper describes the oncological experience on 7,216 patients at two cancer units initiated by one medical team in 1975-1977 at Assaf Harofeh Medical Center in Israel (predominantly serving a Jewish population, 4,671 cases) and at the West Bank Cancer Unit (WBCU), which serves an Arab population (2,545 cases). The two centers have the unique feature of serving two populations residing in close geographic proximity but differing in many cultural and socioeconomic characteristics. Data from the ongoing cancer registries in these two centers are summarized and compare the demographic characteristics of the two study groups, anatomic sites of cancer, methods of diagnosis and extent of disease. The findings at the two centers suggest the presence of different risk factors influencing the site distributions of cancers seen in the two populations served. Among the findings, significantly higher (p less than 0.05) estimated relative risks for cancers of the digestive and urinary-genital systems are observed in each sex group at AHMC than at WBCU. Alternatively, the estimated risk of head and neck cancers was significantly higher among both males and females at WBCU compared with their counterparts at AHMC. Differences in risk were also noted for a number of specific anatomic sites of cancer.