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Zanosar (Streptozocin) - Summary

 



WARNING

ZANOSAR should be administered under the supervision of a physician experienced in the use of cancer chemotherapeutic agents.

A patient need not be hospitalized but should have access to a facility with laboratory and supportive resources sufficient to monitor drug tolerance and to protect and maintain a patient compromised by drug toxicity. Renal toxicity is dose-related and cumulative and may be severe or fatal. Other major toxicities are nausea and vomiting which may be severe and at times treatment-limiting. In addition, liver dysfunction, diarrhea, and hematological changes have been observed in some patients. Streptozocin is mutagenic. When administered parenterally, it has been found to be tumorigenic or carcinogenic in some rodents.

The physician must judge the possible benefit to the patient against the known toxic effects of this drug in considering the advisability of therapy with ZANOSAR. The physician should be familiar with the following text before making a judgment and beginning treatment.

 

ZANOSAR SUMMARY

ZANOSAR® (streptozocin sterile powder)

Each vial of ZANOSAR contains 1 g of the active ingredient streptozocin 2-deoxy-2 [[(methylnitrosoamino)carbonyl]amino]-α (and ß)-D-glucopyranose and 220 mg citric acid anhydrous. ZANOSAR is available as a sterile, pale yellow, freeze-dried preparation for intravenous administration. The pH was adjusted with sodium hydroxide. When reconstituted as directed, the pH of the solution will be between 3.5 and 4.5.

ZANOSAR is indicated in the treatment of metastatic islet cell carcinoma of the pancreas. Responses have been obtained with both functional and nonfunctional carcinomas. Because of its inherent renal toxicity, therapy with this drug should be limited to patients with symptomatic or progressive metastatic disease.


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NEWS HIGHLIGHTS

Media Articles Related to Zanosar (Streptozocin)

Risk For Pancreatic Cancer Not Increased By Hepatitis B
Source: Liver Disease / Hepatitis News From Medical News Today [2009.11.02]
A Henry Ford Hospital study found that hepatitis B does not increase the risk for pancreatic cancer - and that only age is a contributing factor. The results contradict a previous study in 2008 that suggested a link between pancreatic cancer and previous hepatitis B infection. Hepatitis B is an inflammation of the liver caused by a viral infection.

New Hope for Treatment of Pancreatic Cancer
Source: MedicineNet Pancreatic Cancer Specialty [2009.09.25]
Title: New Hope for Treatment of Pancreatic Cancer
Category: Health News
Created: 9/25/2009 8:10:00 AM
Last Editorial Review: 9/25/2009

Patrick Swayze Dies of Pancreatic Cancer
Source: MedicineNet Pancreatic Cancer Specialty [2009.09.15]
Title: Patrick Swayze Dies of Pancreatic Cancer
Category: Health News
Created: 9/15/2009 9:27:00 AM
Last Editorial Review: 9/15/2009 9:27:00 AM

Pancreatic Cancer Deaths Higher for Blacks
Source: MedicineNet Pancreatic Cancer Specialty [2009.09.03]
Title: Pancreatic Cancer Deaths Higher for Blacks
Category: Health News
Created: 9/2/2009 4:10:00 PM
Last Editorial Review: 9/3/2009

Blood Test May Spot Pancreatic Cancer Early
Source: MedicineNet Pancreatic Cancer Specialty [2009.09.02]
Title: Blood Test May Spot Pancreatic Cancer Early
Category: Health News
Created: 9/1/2009 2:10:00 PM
Last Editorial Review: 9/2/2009

more news >>

Published Studies Related to Zanosar (Streptozocin)

Phase II/III study of doxorubicin with fluorouracil compared with streptozocin with fluorouracil or dacarbazine in the treatment of advanced carcinoid tumors: Eastern Cooperative Oncology Group Study E1281. [2005.08.01]
PURPOSE: Optimal treatments for metastatic carcinoid tumor remain undefined, and the role of chemotherapy for symptomatic patients with progressive disease is uncertain... CONCLUSION: Response to all three treatment regimens were modest. FU/STZ improved survival compared with the doxorubicin-based regimen, suggesting that the combination should be considered to be an active regimen of therapy when chemotherapy is judged to be an option for selected patients with carcinoid tumors.

Losartan, an Angiotensin type I receptor, restores erectile function by downregulation of cavernous renin-angiotensin system in streptozocin-induced diabetic rats. [2009.03]
INTRODUCTION: The high incidence of erectile dysfunction (ED) in diabetes highlights the need for good treatment strategies. Recent evidence indicates that blockade of the angiotensin type I receptor (AT1) may reverse ED from various diseases. AIM: To explore the role of cavernous renin-angiotensin system (RAS) in the pathogenesis of diabetic ED and the role of losartan in the treatment of diabetic ED... CONCLUSIONS: The cavernous RAS plays a role in modulating erectile function in corpora cavernosa and is involved in the pathogenesis of diabetic ED. ARB can restore diabetic ED through downregulating cavernous RAS.

Strontium fructose 1,6-diphosphate alleviates early diabetic testopathy by suppressing abnormal testicular matrix metalloproteinase system in streptozocin-treated rats. [2009.02]
OBJECTIVES: Male hypogonadism is frequently associated with testopathy in patients with type 2 diabetes and in middle-aged males. We hypothesized that abnormal matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) in testis have large roles to play in male hypogonadism. It has been found in diabetic rats that a novel compound, strontium fructose 1,6-diphosphate (FDP-Sr), with extra high energy supply, could reverse male hypogonadism by normalizing MMP-9 and TIMPs in the testis. We investigated whether FDP-Sr could be promising in treating diabetic testopathy... CONCLUSIONS: FDP-Sr or testosterone propionate significantly normalized expression and activity of the MMPs-TIMPs system to attenuate changes in serum testosterone, marker enzymes and histology in testis. Effects of FDP-Sr were dose-dependent and comparable with those of testosterone propionate. By supplying extra energy, FDP-Sr could be promising in treating diabetic testopathy by normalizing abnormal MMP-9 and its endogenous inhibitors in testes.

Taurine rescues vascular endothelial dysfunction in streptozocin-induced diabetic rats: Correlated with downregulation of LOX-1 and ICAM-1 expression on aortas. [2008.11.12]
Macroangiopathy is a major complication of diabetes mellitus in which dysfunction of vascular endothelium induced by excessive oxidative stress is an early and key determinant.In conclusion, taurine improves vascular endothelial dysfunction induced by experimental type 1 diabetes and this effect might be associated with downregulation of LOX-1 and ICAM-1 expression on aortic vascular endothelium via its antioxidative property.

Metabolic effects of various antidiabetic and hypolipidaemic agents on a high-fat diet and multiple low-dose streptozocin (MLDS) mouse model of diabetes. [2008.09]
Insulin resistance and subsequent insulin secretory defect are two main features of type 2 diabetes and associated metabolic disorders...

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Clinical Trials Related to Zanosar (Streptozocin)

Avastin, Fluorouracil, Doxorubicin and Streptozocin in Locally Advanced and Metastatic Pancreatic Endocrine Tumors [Recruiting]
Open label, single-arm phase II study of avastin combined with fluorouracil, doxorubicin and streptozocin administered in 28-day cycles. Treatment will continue until progression of disease, or until withdrawal due to toxicity, or up to a maximum of 12 cycles (48 weeks). In order to reduce the risk of cardiac toxicity, doxorubicin will be administered for a maximum of 8 cycles. If disease has not progressed after 12 cycles of treatment, avastin monotherapy will continue until disease progression or withdrawal due to toxicity.

Capecitabine and Streptozocin With or Without Cisplatin in Treating Patients With Unresectable or Metastatic Neuroendocrine Tumors [Recruiting]
RATIONALE: Drugs used in chemotherapy, such as capecitabine, streptozocin, and cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. It is not yet known whether giving capecitabine together with streptozocin is more effective with or without cisplatin in treating neuroendocrine tumors.

PURPOSE: This randomized phase II trial is studying giving capecitabine together with streptozocin to see how well it works compared with or without cisplatin in treating patients with unresectable or metastatic neuroendocrine tumors.

International Study: Comparison of Two Treatments for Adrenocortical Cancer [Recruiting]
Background:

- There is no medical consensus about the best treatment for advanced adrenocortical

cancer (ACC) that cannot successfully be treated with surgery alone.

- In 2003, the International Consensus Conference on Adrenal Cancer recommended two

chemotherapy regimens - etoposide, doxorubicin, cisplatin plus mitotane and

streptozotocin plus mitotane- as the best choices until better data could be obtained. All the drugs in the two options have been shown effective against advanced ACC, but they have different side effects.

Objectives:

- To determine which of the chemotherapy regimens described above is best to start with

in patients with ACC that cannot be surgically removed.

- To determine if there is a way to identify which patients will respond to a certain

therapy.

Eligibility:

- Patients 18 years of age and older from the USA, Scandinavia, Germany, Italy, France, The

Netherlands, Belgium, the UK, Canada and Australia who have adrenocortical cancer that cannot be cured with surgery alone.

Design:

- Chemotherapy: Patients are randomly assigned to start with one of the two study

regimens. Patients whose tumor continues to grow during treatment are offered the alternative therapy. All patients receive daily tablets of mitotane. In addition, they have one of the following two regimens:

- Streptozotocin every 3 weeks for up to six cycles. The first cycle is given on days 1,

2, 3, 4 and 5 and subsequent cycles are given on day 1 only.

- Cisplatin plus etoposide plus doxorubicin every 4 weeks for up to six cycles.

Doxorubicin is given on day 1, etoposide is given on days 2, 3 and 4 and cisplatin is given on days 3 and 4.

- CT scans of the chest, abdomen and pelvis approximately once every 8 weeks.

- Physical examination, routine blood tests and a check of side effects at the start of

each treatment cycle.

- Blood test to determine if the hormones produced by some adrenocortical cancers have

any effect on the immune system.

- Analysis of genetic markers in blood and tumor tissue for comparison with tumor growth

and patient survival to determine if this can help identify which patients will respond to a certain therapy.

- Optional procedures:

- Storage of blood and tissue samples for future research.

- Completion of quality-of-life questionnaires every 2 months.

Phase II Study of Carmustine, Streptozocin, and Mercaptopurine for Refractory or Recurrent Brain Neoplasms [Active, not recruiting]
OBJECTIVES:

I. Assess the clinical response of patients with refractory or recurrent brain neoplasms treated with carmustine, streptozocin, and mercaptopurine.

Combination Chemotherapy in Patients With Zollinger-Ellison Syndrome and Tumors of the Pancreas [Completed]
Patients with Zollinger-Ellison Syndrome suffer from ulcers of the upper gastrointestinal tract, higher than normal levels of gastric acid, and tumors of the pancreas known as non-beta islet cell tumors.

Prior to the use of drugs to cure the ulcers, patients typically died due to severe ulcers. Because of such effective drugs to treat the ulcers it is more common to see patients dying due to the pancreatic tumors.

The study will observe patients suffering from Zollinger-Ellison Syndrome and non-beta islet cell tumors and determine the effectiveness of combined chemotherapy with streptozotocin, 5-fluorouracil, and doxorubicin.

more trials >>

Page last updated: 2009-11-02

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