Chemotherapy of metastatic sweat gland carcinoma. A retrospective review

Sweat gland carcinoma (SGC) is a rare malignancy of the skin. though many patients with SGC die of disseminated metastases, little is known regarding the value of systemic chemotherapy for this disease. We reviewed the records of 20 patients with metastatic SGC who were treated with chemotherapy at Memorial Hospital between 1968 and 1983. A large variety of drugs were given. Although only a few patients were treated with any given regimen, metastatic SGC appears to be poorly responsive to a wide variety of chemotherapeutic regimens. Five major responses were observed in 30 chemotherapy trials performed in 17 patients with measurable/evaluable disease. No patient responded to single agent therapy alone. In this small group of patients, SGC appears to be a relatively chemotherapy resistant tumor. Larger, group-wide or inter-group trials are needed to prospectively evaluate the use of chemotherapy in this disease. Doxorubicin and cyclophosphamide, the two drugs used most commonly in those combinations where responses were seen, appear to be reasonable choices for initial treatment of patients with metastatic disease. Our review does not provide data to support the empiric use of chemotherapy in an adjuvant setting.     

Clinical trial: vitamin D3 treatment in Crohn’s disease – a randomized double‐blind placebo‐controlled study

Aliment Pharmacol Ther 2010; 32: 377–383

Summary

Background Vitamin D has immune‐regulatory functions in experimental colitis, and low vitamin D levels are present in Crohn’s disease. Aim To assess the effectiveness of vitamin D3 treatment in Crohn’s disease with regard to improved disease course. Methods We performed a randomized double‐blind placebo‐controlled trial to assess the benefits of oral vitamin D3 treatment in Crohn’s disease. We included 108 patients with Crohn’s disease in remission, of which fourteen were excluded later. Patients were randomized to receive either 1200 IU vitamin D3 (n = 46) or placebo (n = 48) once daily during 12 months. The primary endpoint was clinical relapse. Results Oral vitamin D3 treatment with 1200 IU daily increased serum 25OHD from mean 69 nmol/L [standard deviation (s.d.) 31 nmol/L] to mean 96 nmol/L (s.d. 27 nmol/L) after 3 months (P < 0.001). The relapse rate was lower among patients treated with vitamin D3 (6/46 or 13%) than among patients treated with placebo (14/48 or 29%), (P = 0.06). Conclusions Oral supplementation with 1200 IE vitamin D3 significantly increased serum vitamin D levels and insignificantly reduced the risk of relapse from 29% to 13%, (P = 0.06). Given that vitamin D3 treatment might be effective in Crohn’s disease, we suggest larger studies to elucidate this matter further. ClinicalTrial.gov(NCT00122184).