3(Amino-1,1-hydroxypropylidene) bisphosphonate (APD) for hypercalcaemia of breast cancer.

The effect of a single dose of APD on hypercalcaemia has been studied in advanced breast cancer. Twenty-five patients were rehydrated intravenously for 48 h. Twenty-three remained hypercalcaemic and received 5-15 mg APD as a 2 h infusion. Eighteen patients achieved normocalcaemia, 15 after a dose of less than or equal to 15 mg. One patient died within 24 h from rapidly advancing disease and 4 remained hypercalcaemic. Urinary calcium excretion increased during rehydration as glomerular function improved and tubular reabsorption of calcium fell. After APD, calcium excretion fell to normal in 22/24 patients reflecting inhibition of bone resorption. Hydroxyproline excretion remained high. The effect of a single dose of APD on hypercalcaemia lasted a median of 11 days (range 7-17). Transient fever occurred in 2 patients, but there were no other side effects. The possibility of long-term control of osteolysis using a 2 weekly schedule of APD administration is now being studied

The clinical course of bone metastases from breast cancer.

All patients with carcinoma of the breast seen in this Unit since 1970 were reviewed to study the incidence, prognosis, morbidity and response to treatment of bone metastases. The biological characteristics of the primary tumour were compared in patients relapsing first in bone or liver. Sixty-nine percent of patients dying with breast cancer had bone metastases and bone was the commonest site of first distant relapse. Bone relapse was more common in receptor positive or well differentiated (grade 1) tumours. The median survival was 24 months in those with disease apparently confined to the skeleton compared with 3 months after first relapse in liver. Ten percent of patients with breast cancer developed hypercalcaemia. All had metastatic disease and 85% had widespread skeletal involvement. Fifteen percent of patients with disease confined to the skeleton developed hypercalcaemia. The response in bone to primary endocrine therapy, and chemotherapy, was apparently less than the overall response achieved. A large proportion had apparently static disease reflecting the insensitivity of the UICC assessment criteria. The duration of survival in these patients was similar to responding patients, suggesting a tumour response may occur in the absence of discernable radiological evidence of healing

Clinical course and prognostic factors following bone recurrence from breast cancer.

Three hundred and sixty-seven women presenting to the Breast Unit at Guy's Hospital between 1975 and 1990 whose first distant metastasis was in the skeleton were identified and the influence of a number of patient and tumour characteristics on the development and subsequent prognosis of bone metastases was assessed. One hundred and thirty-nine women had disease that remained clinically confined to the skeleton. They were more likely to be older, with lobular carcinoma and to have presented initially with little or no axillary lymph node involvement. The 228 women who subsequently developed disease at extra-osseus sites were more likely to have poorly differentiated ductal tumours and heavy lymph node involvement at primary diagnosis. On multivariate analysis, the clinical and pathological factors of greatest prognostic importance for survival after the development of bone metastases were histological grade (P = < 0.0001), oestrogen receptor status (P = < 0.0001), bone disease at initial presentation (P = < 0.0001), disease-free interval (P = 0.002) and age (P = 0.006)

Augmentation of cytotoxic drug action and X-irradiation by antibodies.

The effect of an antiserum containing antibodies against cell surface components of PyBHK cells on the action of certain anticancer agents has been studied using a colony formation inhibition assay. The effects of x-rays, chlorambucil, CCNU and possibly ICRF 159 are augmented by the antiserum whereas methotrexate and vinblastine are not

Four-qubit entanglement from string theory

We invoke the black hole/qubit correspondence to derive the classification of four-qubit entanglement. The U-duality orbits resulting from timelike reduction of string theory from D=4 to D=3 yield 31 entanglement families, which reduce to nine up to permutation of the four qubits.Comment: 4 pages, 1 figure, 2 tables, revtex; minor corrections, references adde

Use of positron emission tomography in evaluation of brachial plexopathy in breast cancer patients

18-Fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) has previously been used successfully to image primary and metastatic breast cancer. In this pilot study, 19 breast cancer patients with symptoms/signs referrable to the brachial plexus were evaluated with 18FDG-PET. In 11 cases computerized tomography (CT) scanning was also performed. Of the 19 patients referred for PET study, 14 had abnormal uptake of 18FDG in the region of the symptomatic plexus. Four patients had normal PET studies and one had increased FDG uptake in the chest wall that accounted for her axillary pain. CT scans were performed in 9 of the 14 patients who had positive brachial plexus PET studies; six of these were either normal or showed no clear evidence of recurrent disease, while three CTs demonstrated clear brachial plexus involvement. Of two of the four patients with normal PET studies, one has had complete resolution of symptoms untreated while the other was found to have cervical disc herniation on magnetic resonance imaging (MRI) scan. The remaining two patients almost certainly had radiation-induced plexopathy and had normal CT, MRI and PET study. These data suggest that 18FDG-PET scanning is a useful tool in evaluation of patients with suspected metastatic plexopathy, particularly if other imaging studies are normal. It may also be useful in distinguishing between radiation-induced and metastatic plexopathy. © 1999 Cancer Research Campaig