Continuous exposure to naturally-derived chemotherapy agents such as @entity2879 may theoretically override drug resistance due to overexpression of the multidrug resistance gene product, @entity1262 . @entity619 in high dose may have a similar overriding effect. Data also suggest that @entity1260 both by continuous infusion and when combined with a @entity902 compound may be more effective. Forty-four chemotherapy-refractory/relapsed @entity706 @entity1 received the DICE infusional regimen. The programme consisted of @entity619 40 mg i.v. daily for 4 days, @entity1260 1500 mg mixed with equal dosing of mesna continuously infused i.v. daily for 4 days, @entity900 25 mg i.v. each day for 4 days and @entity2879 150 mg continuously infused i.v. daily for 4 days, all administered every 3 weeks. Doses of @entity1260 and @entity2879 were escalated by 250 mg and 25 mg, respectively, based on @entity1 tolerance, usually lack of myelosuppression. Special hydration was not required. @entity1261 support was provided to @entity1 as required. All @entity1 had disease that had relapsed from or was resistant to @entity3726 or a similar @entity4349 -containing combination regimen. A majority had previously received at least two regimens and 27% had received three or more. Of 44 @entity1 , 32 (73%) achieved a significant response consisting of 18 complete remissions (CR) (41%) and 14 (32%) partial remissions (PR). There were 81% objective responses in large cell @entity706 comprised of 50% CR and 31% PR. Previous response to chemotherapy predicted response to DICE: 83% (25/30) of prior responders vs 50% (7/14) of non-responders had a response to the treatment regimen (p = 0.031, Fisher's exact test). @entity1 not undergoing transplantation had a median time of 8 months on therapy and a mean of 10 months. @entity137 was haematological (36% developing grade III-IV @entity137 ) and neurological (9%). There were only three episodes of clinical @entity2335 or gross haematuria. Infusional DICE is an easily administered and well tolerated programme with significant activity in refractory or relapsed @entity1893 and may be useful as a @entity5 -reductive therapy prior to high-dose chemotherapy and autologous stem cell transplantation.

DICE ( @entity619 , @entity1260 , XXXX , @entity2879 ) infusional chemotherapy for refractory or relapsed @entity1893 ( @entity1893 ).

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity1262 :: ('5243', 'Gene') :: ['p-glycoprotein'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity', 'Toxicity'] @entity1261 :: ('1440', 'Gene') :: ['G-CSF'] @entity706 :: ('MESH:D008223', 'Disease') :: ['lymphoma'] @entity4349 :: ('CHEBI:48120', 'Chemical') :: ['anthracycline'] @entity2335 :: ('MESH:D003556', 'Disease') :: ['cystitis'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumour'] @entity3726 :: ('1649', 'Gene') :: ['CHOP'] @entity900 :: ('MESH:D002945', 'Chemical') :: ['cisplatin'] @entity2879 :: ('MESH:D005047', 'Chemical') :: ['etoposide'] @entity619 :: ('MESH:D003907', 'Chemical') :: ['Dexamethasone', 'dexamethasone'] @entity1260 :: ('MESH:D007069', 'Chemical') :: ['ifosfamide'] @entity1893 :: ('MESH:D008228', 'Disease') :: ['NHL'] @entity902 :: ('MESH:D010984', 'Chemical') :: ['platinum']
@entity900 :: (MESH:D002945,Chemical) :: ['cisplatin']
