Combination chemotherapy with cisplatin, etoposide, and vindesine in non-small cell lung carcinoma: a clinical trial of the EORTC lung cancer working party

A combination of cisplatin (60 mg/m2 on Day 1), etoposide (120 mg/m2 on Days 3, 5, and 7), and vindesine (1.5 mg/m2 on Days 1 and 7), repeated every 3 weeks, was administered to 73 patients with non-small cell bronchogenic carcinoma. After two full courses, the results could be evaluated in 62 patients, 25 (40.3%) of whom responded (five complete responses, 20 partial responses). The median survival for the responding patients (12 months) was significantly superior (P = 0.02) to that of the nonresponding patients. There were three early toxic deaths from sepsis associated with granulocytopenia, and seven patients presented peripheral neuropathy. Although active in non-small cell bronchogenic carcinoma, the combination of cisplatin, etoposide, and vindesine does not appear to be superior to cisplatin-etoposide or cisplatin-vindesine when our previous experience and the results reported from other institutions are considered.

Lactic acidosis: a metabolic complication of extensive metastatic cancer

Lactic acidosis is a rare metabolic complication of cancer. An analysis of the cases reported in the English and French literature shows that all the patients have extensive neoplastic disease. Metastatic hepatic lesions are present in the large majority of cases, suggesting that alteration of liver function is part of the clinical picture. Chemotherapy against the neoplastic disease is the only effective treatment of this type of lactic acidosis.

Clinical phase I trial of marcellomycin with a single-dose schedule

Marcellomycin is a new anthracycline that was proposed for clinical trials on the basis of experimental data suggesting reduced potential for hematologic and cardiac toxicity as compared to conventional anthracyclines. This phase I trial was designed to determine the maximum tolerated dose of marcellomycin at a single-dose schedule. The drug was given as a 15-to 30-min i.v. injection. Eighteen patients with a variety of solid tumors received a median of 2 courses (range: 1-5) at doses of 5-60 mg/m2. Myelosuppression was dose-limiting and somewhat unpredictable. It was characterized by early thrombocytopenia and late leukopenia. It occurred at doses greater than or equal to 40 mg/m2 and resulted in a few cases of infection and hemorrhage. Nausea, vomiting and stomatitis were frequent and occasionally severe. Other common non-hematological toxic effects consisted of local phlebitis and fatigue. Electrocardiographic changes were also encountered. Hair loss was rare and negligible. No antitumor activity could be detected. It appears that phase II trials should be preferably restricted to ambulatory patients and that a dose schedule of 50 mg/m2 repeated every 3 weeks may be proposed for this favorable patient population.

[Late intensive chemotherapy with bone marrow autograft. Pilot study in small cell bronchial cancer]

Following three courses of induction chemotherapy, 23 patients with small cell carcinoma of the lung were treated with a late intensive regimen including autologous bone marrow infusion. Thirteen patients received high doses (2 or 3 times the induction chemotherapy dosage) of cisplatin, adriamycin and etoposide. One patient was probably cured, but renal and mucosal toxicity was observed. Three patients treated with adriamycin, etoposide and cyclophosphamide also developed severe mucositis. The seven remaining patients received high doses of cyclophosphamide (100 to 200 mg/kg) and etoposide (750 to 1000 mg/m2); responses were obtained with moderate toxicity. The long-term survival is not yet known. The usefulness of bone marrow infusion cannot be determined without further studies.

Rhinorrhea and Pseudomonas meningitis associated with a rhinopharyngeal tumor

A patient with a neoplastic tumor of the rhinopharynx had Pseudomonas aeruginosa meningitis, the origin of which could be traced back to an occult CSF fistula caused by the tumor. From a review of the literature, it seems that this is a rare clinical occurrence.

[Hypothermia: a new approach to the treatment of cancer (author's transl)]

Hyperthermia has been known since the last century to be effective against cancer, but it has only developed into a new therapeutic method during the past 20 years. The authors review the theoretical and experimental backgrounds of fever therapy and discuss its local and general applications currently under study, including possible synergistic effects with radiotherapy and/or chemotherapy. Particular attention is paid to systemic hyperthermia.