Developmental and Nutritional Dynamics of Malpighian Tubule Autofluorescence in the Asian Tiger Mosquito Aedes albopictus

Malpighian tubules (MTs) are arthropod excretory organs crucial for the osmoregulation, detoxification and excretion of xenobiotics and metabolic wastes, which include tryptophan degradation products along the kynurenine (KYN) pathway. Specifically, the toxic intermediate 3-hydroxy kynurenine (3-HK) is metabolized through transamination to xanthurenic acid or in the synthesis of ommochrome pigments. Early investigations in Drosophila larval fat bodies revealed an intracellular autofluorescence (AF) that depended on tryptophan administration. Subsequent observations documented AF changes in the MTs of Drosophila eye-color mutants genetically affecting the conversion of tryptophan to KYN or 3-HK and the intracellular availability of zinc ions. In the present study, the AF properties of the MTs in the Asian tiger mosquito, Aedes albopictus, were characterized in different stages of the insect's life cycle, tryptophan-administered larvae and blood-fed adult females. Confocal imaging and microspectroscopy showed AF changes in the distribution of intracellular, brilliant granules and in the emission spectral shape and amplitude between the proximal and distal segments of MTs across the different samples. The findings suggest AF can serve as a promising marker for investigating the functional status of MTs in response to metabolic alterations, contributing to the use of MTs as a potential research model in biomedicine.

Pathogen-Mediated Alterations of Insect Chemical Communication: From Pheromones to Behavior

Pathogens can influence the physiology and behavior of both animal and plant hosts in a manner that promotes their own transmission and dispersal. Recent research focusing on insects has revealed that these manipulations can extend to the production of pheromones, which are pivotal in chemical communication. This review provides an overview of the current state of research and available data concerning the impacts of bacterial, viral, fungal, and eukaryotic pathogens on chemical communication across different insect orders. While our understanding of the influence of pathogenic bacteria on host chemical profiles is still limited, viral infections have been shown to induce behavioral changes in the host, such as altered pheromone production, olfaction, and locomotion. Entomopathogenic fungi affect host chemical communication by manipulating cuticular hydrocarbons and pheromone production, while various eukaryotic parasites have been observed to influence insect behavior by affecting the production of pheromones and other chemical cues. The effects induced by these infections are explored in the context of the evolutionary advantages they confer to the pathogen. The molecular mechanisms governing the observed pathogen-mediated behavioral changes, as well as the dynamic and mutually influential relationships between the pathogen and its host, are still poorly understood. A deeper comprehension of these mechanisms will prove invaluable in identifying novel targets in the perspective of practical applications aimed at controlling detrimental insect species.

Female control of sperm ejection and retention in the cornsilk fly Euxesta eluta (Diptera: Ulidiidae)

Promiscuous mating systems provide the opportunity for females to bias fertilization toward particular males. However, distinguishing between male sperm competition and active female sperm choice is difficult for species with internal fertilization. Nevertheless, species that store and use sperm of different males in different storing structures and species where females are able to expel all or part of the ejaculates after copulation may be able to bias fertilization. We report a series of experiments aimed at providing evidence of female sperm choice in Euxesta eluta (Hendel), a species of ulidiid fly that expels and consumes ejaculates after copulation. We found no evidence of greater reproductive success for females mated singly, multiply with the same male, or mated multiply with different males. Female E. eluta possesses two spherical spermathecae and a bursa copulatrix for sperm storage, with a ventral receptacle. There was no significant difference in storing more sperm in spermathecae 24 h after copulation than immediately after copulation. Females mated with protein-fed males had greater reproductive success than similar females mated to protein-deprived males. Protein-fed females prevented to consume the ejaculate, retained more sperm when mated to protein-fed males than when mated to protein-deprived males. Our results suggest that female E. eluta can exert control of sperm retention of higher quality males through ejaculate ejection.

Methoprene treatment and its effect on male reproductive organ size and female remating in a fruit fly

Methoprene, a juvenile hormone analog, is used to accelerate sexual maturation in males of species of economic importance in support to the sterile insect technique (SIT). In the SIT, mass-reared sterile males are released into the field and need to survive until they reach sexual maturation, find a wild female, mate with her and then induce female sexual refractoriness, so she will not remate with a wild counterpart. The use of methoprene shortens the time between release and copulation. However, in South American fruit flies, Anastrepha fraterculus, the ability of methoprene-treated males to inhibit female remating has been shown to be lower than wild males, when methoprene was applied by pupal immersion or topical application. Here we evaluated the possibility of incorporating methoprene into the male diet at different doses and the ability of those males to inhibit female remating, as well as the effect of methoprene on male reproductive organ size, due to the possible correlation between male accessory gland size and their content, and the role of male accessory gland proteins in female inhibition. We found that A. fraterculus males fed with methoprene in the adult protein diet at doses as high as 1% were less likely to inhibit female remating, however, at all other lower doses males had the same ability as untreated males to inhibit female remating. Males fed with methoprene had bigger male accessory glands and testes compared to methoprene-deprived males. We demonstrate that the incorporation of methoprene in adult male diets is possible in this species and potentially useful as a post-teneral, pre-release supplement at doses as low as 0.01%. Even at higher doses, the percentage of females remating after 48 h from the first copulation is sufficiently low in this species so as not compromise the efficiency of the SIT.

[Survey for Caregivers of People with Autism Spectrum in Chile: Access to Health and Education Services, Satisfaction, Quality of Life And Stigma]

INTRODUCTION

People on the Autism Spectrum (AS) face multiple health, education, social, and economic pro blems. There is limited available information in Chile.

OBJECTIVE

To describe the access and satisfac tion with health and education services, family and economic impact, stigma, and quality of life of people with AS and their families in Chile.

SUBJECTS AND METHOD

Parents/caregivers of AS persons completed the Caregiver Needs Survey, developed by Autism Speaks, which includes demographic information, characteristics of AS persons (previously published), use of health and education servi ces, parents/caregivers' perceptions of satisfaction, impact, stigma, and quality of life.

RESULTS

291 caregivers (86% mothers) of 291 AS persons participated, 89% were male, aged 1-40 years (X:10.4 SD:6.1). Limited and unspecific access to health services is reported. 77% are regularly attending a standard or special school system. Families pay for over 60% of therapies/medical care and over 40% of specific educational support, and 25% report difficulties in accessing services. The family income is affected by resignation (35%) or reduced working hours (46%). Stigma is associated with possi ble discrimination and feelings of helplessness. The main priorities mentioned for a better quality of life are support for inclusive schooling, better adjustment at home, and improved socialization.

CONCLUSIONS

This survey provides relevant information about the needs, barriers, and challenges of AS people in Chile and highlights the difficulties in accessing health services and the severe impact on family income. Feelings of stigma, discrimination, and helplessness are reported. Collaborative strategies are needed to improve the quality and access to services and to reduce the economic and mental health burden on the family.

Life history, dormancy regulation, reproductive physiology and basic behaviour of the subtropical fruit fly Rhagoletotrypeta pastranai (Diptera:Tephritidae)

With the purpose of broadening knowledge on the evolution of life history strategies and behaviour of fruit flies within the tribe Carpomyini, the natural history and mating behaviour of the poorly known species Rhagoletotrypeta pastranai Aczél, are described for the first time. Larvae of R. pastranai were recovered from infested Celtis tala Gillies ex Planch and Celtis iguanaea (Jacq.) Sarg. during a 2-month fruiting period. Adults emerged from the recovered pupae after an average of 144.9 ± 3.9 days for females and 143.2 ± 3.38 days for males, suggesting that most individuals became dormant. Results of a variable winter length study suggested that environmental factors other than winter length may regulate dormancy/diapause duration in this subtropical species. Under laboratory conditions, R. pastranai adults lived an average of 51.13 ± 3.06 days in case of females and 48.08 ± 3.76 days in case of males, and required 5-15 days to reach sexual maturity. Behavioural observations under confinement revealed scarce sexual activity but sufficed to determine that, as in other members of the tribe Carpomyini, R. pastranai exhibits a male resource defence mating system. We discuss our findings emphasizing the importance of documenting the natural history and behaviour of unknown species of family Tephritidae and additionally, we highlight the necessity of future research to understand factors regulating dormancy/diapause and the evolution of life history strategies and sexual behaviour of subtropical species.

Survey for caregivers of people in the autism spectrum in Chile: first concerns, age of diagnosis and clinical characteristics

INTRODUCTION

Autism Spectrum Disorders (ASD) are neurodevelopmental disorders of increasing prevalence. People with ASD have multiple health, education, and community needs, yet there is little information about their situation in Chile.

OBJECTIVE

To learn about the demographic and clinical characteristics, caregiver's first concerns, and age of diagnosis of ASD individuals.

PATIENTS AND METHOD

Participants were parents/caregivers of ASD persons, who answered the Caregiver Needs Survey, developed by Autism Speaks specifically for this purpose, and translated into Spanish. The survey is comprised of 4 sections: demographic information, characteristics of the ASD individual, past and present use of Health and Education Services, and parents/caregivers' perceptions of satisfaction, impact, stigma, and quality of life. Data from the first two sections are reported in this paper.

RESULTS

The survey was answered by 291 caregivers (86% mothers) of 291 mostly male ASDs (89%), aged between 1-40 years (X: 10.4 SD: 6.1). The average age of parents' first concerns was 29.2m (SD: 23.8) where the main ones were: interaction difficulties (79.4%), unusual response to sensory stimuli (69.8%), behavioral problems (65.3%), unusual gestures/movements (64.3%), and lack of eye contact (63.6%). The ave rage age of diagnosis was 58m (SD: 36.5), with an average delay of diagnosis of 29m. The diagnosis was most frequently made by pediatric neurologists (44.7%), child psychiatrists (19.2%), and pedia tricians (5.5%). The most frequent comorbidities were language impairment, cognitive deficit, and behavioral problems.

CONCLUSIONS

The late age of diagnosis of ASD and the large gap between the age of first concerns and diagnosis, represent a critical loss of treatment opportunities and jeopardize the chances of a better long-term outcome.

Irradiation dose does not affect male reproductive organ size, sperm storage, and female remating propensity in Ceratitis capitata

The Mediterranean fruit fly Ceratitis capitata is a globally invasive pest, often controlled with the sterile insect technique (SIT). For the SIT, mass-rearing of the target insect followed by irradiation are imperatives. Sterile males are often less able to inhibit female remating and transfer less number of sperm, and even irradiation could affect male reproductive organs, with consequences for their ability to inhibit female remating. On the other hand, male age could affect their ability to modulate female response after mating. Here, we evaluated the quality of the genetic sexing strain Vienna-8-tsl mass-reared in Bioplanta San Juan, Argentina, under laboratory conditions, with regard to: (i) the ability of sterile males irradiated at 100 or 140 Gy to inhibit female remating, in the same day and at 24 h of first copulation; (ii) the ability of 3, 4 or 5 day-old sterile males to inhibit female remating at 24 h of first copulation, and (iii) the effect of a reduction in irradiation doses on the number of sperm stored by females and reproductive organ size in virgin males. Sterile males were better able than wild males to inhibit female remating in the same day of first copulation and as able as wild males 1 day after first copulation. Male age did not affect their ability to inhibit female receptivity. Number of sperm stored by females, testes size and ectodermal accessory glands size were not affected by male identity, while sterile 100 Gy males had larger mesodermal accessory glands than control lab males. A reduction in irradiation dose does not impact any variable measured, except for percentage of sperm-depleted females: females mated with sterile 100 Gy males had lower probabilities to store sperm. The results showed here are very encouraging for tsl Vienna 8 strain reared in Argentina and are discussed in comparison with previous studies in C. capitata female remating with dissimilar results.

Trace element mobility in soils seven years after the Aznalcóllar mine spill

The long-term influence of the Aznalcóllar mine spill on soils was studied seven years after the accident in the area of Vado del Quema. Soils where the pyritic sludge was not removed after the cleaning operations and soils where this process was accomplished successfully were sampled and studied in detail. Sludge and soil horizons were characterised, determining their physico-chemical parameters, mineralogy and the total concentrations of major and trace elements. Moreover, leaching studies were performed using batch tests. The main mineralogical changes detected in the soil beneath the weathered sludge are the neo-formation of jarosite, gypsum and sainfeldite, together with the almost total depletion of calcite. An important acidification of soil has been also produced, especially in the uppermost soil layers. These two factors show to be the main responsible for the vertical distribution and leachability displayed by trace elements. Critical total concentrations were found for most trace elements in the soil still affected by the sludge weathering. Furthermore, the Cd and Zn leachable contents showed to be extremely high. Therefore, in those areas affected by the mine spill where the removal of sludge was not accomplished properly, special care should be paid to trace elements highly mobile in acidic conditions. Additional restoration measures should be undertaken to avoid further pollutant dispersion.

Long-term outcome of a phase II study of weekly docetaxel with a short course of estramustine and enoxaparine in hormone-resistant prostate cancer patients

OBJECTIVE

The objective was to define the toxicity and activity of weekly docetaxel administered with a short course of estramustine and enoxaparine in patients with hormone-resistant prostate cancer (HRPC).

PATIENTS AND METHODS

Twenty-four patients were treated with the next regimen: weekly docetaxel 36 mg/m(2) iv for three consecutive weeks every 28 days, and estramustine 280 mg three times a day for three consecutive days beginning the day before docetaxel (days 1-3, 8-10 and 15-17). In order to prevent thromboembolic events, 40 mg of subcutaneous enoxaparine was administered daily sc on the same days as estramustine. Primary endpoints were: toxicity, especially the presence of thromboembolic events, PSA response rate and response in measurable disease. Secondary endpoints were: time to PSA progression and overall survival.

RESULTS

Nineteen of 24 patients (79.1%, 95% CI 71-87%) had a PSA response = or >50%. Four of the eleven patients with measurable disease had a partial response. The median time to PSA progression was 7 months (CI 95%: 6.5-9) and the median survival was 19 months (IC 95%: 11-24). Toxicity was manageable with no treatment- related mortality. Only two patients had grade 4 neutropenia. Two patients had thrombotic events, one deep venous thrombosis and one stroke. The main grade 3 non-haematologic toxicity was diarrhoea and asthenia, both in 25% of patients.

CONCLUSIONS

Weekly docetaxel with a short course of estramustine and enoxaparine is active and tolerable in HRPC patients. The observed incidence of thrombosis was lower than previously reported but the association of enoxaparine was not enough to completely prevent the thromboembolic events.

Randomized phase II trial of carboplatin versus paclitaxel and carboplatin in platinum-sensitive recurrent advanced ovarian carcinoma: a GEICO (Grupo Espanol de Investigacion en Cancer de Ovario) study

BACKGROUND

The aim of this study was to determine whether the response rate for the paclitaxel-carboplatin combination is superior to carboplatin alone in the treatment of patients with platinum-sensitive recurrent ovarian carcinoma.

PATIENTS AND METHODS

Patients with recurrent ovarian carcinoma, 6 months after treatment with a platinum-based regimen and with no more than two previous chemotherapy lines, were randomized to receive carboplatin area under the curve (AUC) 5 (arm A) or paclitaxel 175 mg/m(2) + carboplatin AUC 5 (arm B). The primary end point was objective response, following a 'pick up the winner' design. Secondary end points included time to progression (TTP), overall survival, tolerability and quality of life (QoL).

RESULTS

Eighty-one patients were randomized and included in the intention-to-treat analysis. The response rate in arm B was 75.6% [26.8% complete response (CR) + 48.8% partial response (PR)] [95% confidence interval (CI) 59.7% to 87.6%] and 50% in arm A (20% CR + 30% PR) (95% CI 33.8% to 66.2%). No significant differences were observed in grade 3-4 hematological toxicity. Conversely, mucositis, myalgia/arthralgia and peripheral neurophaty were more frequent in arm B. Median TTP was 49.1 weeks in arm B (95% CI 36.9-61.3) and 33.7 weeks in arm A (95% CI 25.8-41.5). No significant differences were found in the QoL analysis.

CONCLUSIONS

Paclitaxel-carboplatin combination is a tolerable regimen with a higher response rate than carboplatin monotherapy in platinum-sensitive recurrent ovarian carcinoma.

Photochemistry of 3-substituted bicyclo[3.1.0]hex-3-en-2-ones. Regioselective synthesis of ortho-substituted phenols by Pauson-Khand reaction

[reaction: see text] 3-Substituted bicyclo[3.1.0]hex-3-en-2-ones 3, easily obtained by Pauson-Khand reaction between terminal alkynes and cyclopropene, have been quantitatively converted into ortho-substituted phenols 4 by irradiation with UV light (350 nm). The kinetics and mechanism of this photochemical process have been studied by means of FT-IR and semiempirical (AM1 3x3 CI) calculations.

Intermolecular Pauson-Khand reactions of cyclopropene: a general synthesis of cyclopentanones

[reaction: see text] The Pauson-Khand reaction of cyclopropene with a variety of terminal alkynes has been studied. The best reaction conditions involve NMO activation in CH(2)Cl(2) at -35 degrees C. In this way, 3-substituted-bicyclo[3.1.0]hex-3-en-2-ones have been obtained in good to excellent yields. As a synthetic application, several types of substituted cyclopentenones have been prepared from these cycloadducts by protocols involving conjugate addition and reductive ring opening.

Asymmetric Pauson-Khand reactions using camphor-derived chelating thiols as chiral controllers

A convenient procedure for the preparation of enantiopure 10-(R-thio)-2-exo-bornanethiols from (1S)-camphor-10-thiol has been developed. The ethynyl derivatives of these thiols gave excellent diastereoselectivities (up to 98:2) in Pauson-Khand reactions with norbornene and norbornadiene through the intermediacy of a chelated dicobalt pentacarbonyl complex. Thermal reaction conditions starting from the preformed chelated complex gave better results than N-oxide-promoted runs with in situ generation of the chelated intermediate. The corresponding adducts have been elaborated through a protocol consisting of conjugate addition, samarium iodide-promoted cleavage of the chiral auxiliary, and retro-Diels-Alder reaction to afford 4-substituted 2-cyclopentenones in high enantiomeric purity.

A concise enantioselective entry to the synthesis of deoxy-azasugars

[reaction: see text] A concise enantioselective preparation of oxazolidinylpiperidine 4, a key intermediate in the synthesis of glycosidase inhibitors such as 1-deoxymannojirimycin or 1-deoxygalactostatin, has been developed. Sharpless catalytic asymmetric epoxidation of (E)-2,4-pentadienol followed by treatment with allyl isocyanate afforded epoxy carbamate 8. Regioselective intramolecular ring opening promoted by sodium bis(trimethylsilyl)amide and ring-closing metathesis provided the bicyclic intermediate 4 in high enantiomeric purity. The four-step sequence takes place in 51% overall yield.

Metastatic endometrial cancer in lung and liver: complete and prolonged response to hormonal therapy with progestins

A double complete and prolonged response of metastatic endometrial carcinoma to medroxyprogesterone is reported. A 61-year-old woman with metastatic endometrial carcinoma in lung and liver achieved a complete clinical response with medroxyprogesterone lasting for 2 years. She discontinued the therapy by herself and developed a pulmonary relapse, which disappeared after retreatment with the same hormonal therapy. At present, she is alive without evidence of disease 6 years after starting progestins for metastatic disease and 14 years after treatment of the primary tumor. Progestin therapy in metastatic endometrial carcinoma is discussed, emphasizing the factors predicting response.

Superiority of sequential versus concurrent administration of paclitaxel with etoposide in advanced non-small cell lung cancer: comparison of two Phase II trials

Paclitaxel and etoposide are two chemotherapy agents with broad cytotoxic activity and different mechanisms of action and resistance. Preclinical studies of their combined cytotoxicity have yielded conflicting results. We performed two sequential Phase II trials using different sequence schedules of paclitaxel and etoposide as first-line treatment in advanced non-small cell lung cancer (NSCLC). Forty-four patients with stage IIIB or IV NSCLC were included between July 1995 and September 1996. All patients received etoposide at 100 mg/m2, given as an i.v. infusion on days 1, 2, and 3. The first 20 patients (part A) also received paclitaxel at 175 mg/m2 as a 3-h infusion on day 1, immediately prior to etoposide. The subsequent 24 patients (part B) were given the same paclitaxel dose, but on day 4. Grade 3-4 granulocytopenia was seen in 70% of the patients in part A and in 37% of those in part B (P = 0.04). Twenty-five % of the courses in part A and 4% of the courses in part B were associated with granulocyte nadir < or =500/microl (P = 0.00006). No responses were observed in part A, although disease was stabilized in 14 patients (70%). In part B, there were two complete responses and seven partial responses, for an overall response rate of 37.5% (95% confidence interval, 21-58%). In conclusion, toxicity and antitumor activity of the paclitaxel/etoposide combination may be sequence dependent. Our findings suggest that etoposide followed by paclitaxel is well tolerated and has greater activity in NSCLC than concurrent administration.

Dose-escalated paclitaxel in 1-hour infusion with a fixed dose of cisplatin in previously untreated advanced ovarian cancer: a phase II trial of the Spanish Group for Ovarian Cancer

This phase II trial was planned to study the efficacy and toxicity of a fixed dose of cisplatin plus paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) given over 1 hour with intrapatient dose escalation. Patients with advanced epithelial ovarian cancer (stages IIB-IV); Eastern Cooperative Oncology Group performance status < or = 2; normal renal, liver, and bone marrow function; and evaluable residual disease after debulking surgery were accrued. Paclitaxel was given over 1-hour infusion and dose was escalated from 175 to 200 and 225 mg/m2 if nadir neutrophil counts were > or = 1000/microL, platelets were > or = 100,000/microL, and neurotoxicity was less than grade 2. Cisplatin was given after paclitaxel at a fixed dose of 80 mg/m2. Six courses at 3-week intervals were planned. From May 1995 to August 1996, 68 patients were entered. Paclitaxel could not be escalated in six patients, another six received up to 200 mg/m2, and 45 received 225 mg/m2. Three hundred seventy-five courses were given: 27.7% at 175 mg/m2, 19.2% at 200 mg/m2, and 53.1% at 225 mg/m2. All patients were evaluable for toxicity, and 67 were evaluable for response. Thirty-five patients had a complete clinical response (51.4%), 20 had a partial response (29.4%), six had stable disease (8.9%), and six progressed on therapy (8.9%). Overall response rate was 80.8 (95% confidence interval, 71.3% to 90.1%). Second-look laparotomy was performed in 32 patients, and 20 of them (62.5%) had a pathologic complete remission. Grade 3 or 4 neutropenia was seen in 26 patients (38%), but only one had fever. Severe thrombocytopenia was not seen. Peripheral neurotoxicity (grade 1, 39.7%; grade 2, 42.6%; and grade 3, 8.8%) was dose-limiting. It is too early to report on time to progression and survival, and these data are not yet available. This combination of cisplatin with escalating doses of paclitaxel is feasible and very active, but the high incidence of peripheral neurotoxicity may limit its use.

Dietary deficiency or enrichment of essential fatty acids modulates tumorigenesis in the whole body of cobalt-60-irradiated mice

The effect of dietary polyunsaturated fatty acids (PUFAs) on whole body-induced tumorigenesis was assayed in mice fed on essential fatty acid sufficient (EFAS) or essential fatty acid deficient (EFAD) diets following cobalt-60 irradiation. Four groups of mice were maintained, one on a control stock diet and three on experimental diets: a) without added fat (fat free, FF); b) containing 5% olein (O), rich in n-9; and c) containing 5% corn oil, rich in n-6 EFA (CO). Only mice fed on FF or O diets showed clinical and biochemical signs of EFAD. Total incidence of tumors showed an increase in FF (P < 0.02) and O (P < 0.03) mice. Tumors developed mostly in the liver in each of the EFAD groups (P < 0.001). Slight promoting activity on lung tumorigenesis was recorded in the CO group when this parameter was compared in EFAD and EFA sufficient mice. It may be concluded that, when a tumor initiator injures the body as a whole, EFAD, achieved either through a fat-free or an oleic-supplemented diet, behaves as a general promoting condition for tumorigenesis. The borderline tumorigenic effect of n-6 corn oil on the lungs suggests that this effect, when present, is target specific.

[A randomized study of navelbine compared to navelbine and cisplatin compared to vindesine and cisplatin in the treatment of inoperable non-small-cell lung carcinoma. The results of a European multicenter study including 612 patients]

The results are reported of three chemotherapy schedules in a multicentric, international, randomized trial of the therapy of unresectable non small cell lung carcinoma which included 612 patients. The antitumoral efficiency of the cisplatin + vindesine combination (200 patients) was compared with that of navelbine (206 patients), a recently available vinca alkaloid, and with a third therapeutical leg with cisplatin + navelbine (206 patients). After a very thorough response evaluation the combination cisplatin + navelbine obtained a response rate higher than the other combination (30% vs. 19%; p = 0.02) and also than navelbine (30% vs. 14%; p < 0.001). The median response durations were 9.3, 9.9, and 7.8 months for the combination with navelbine, vindesine and the new vinca alkaloid alone, respectively. After a median follow-up period of 26 months the combination cisplatin + navelbine achieved a higher survival rate than the combination cisplatin + vindesine (40 vs. 32 weeks) and navelbine (40 vs 31 weeks; p = 0.045). The most important toxicity with the combination cisplatin + navelbine was neutropenia, which although relevant in number was not of long duration. In summary, navelbine is an active agent in the therapy of non small cell lung carcinoma. In this trial the therapeutic superiority of its combination with cisplatin over the combination cisplatin + vindesine was observed; likewise, it was also more efficient than monotherapy with navelbine.

Comparison of two chemotherapeutic regimens--mitomycin + vindesine + cisplatin (MVP) vs. mitomycin + ifosfamide + cisplatin (MIP)--in advanced non-small-cell lung cancer. ONCOPAZ Cooperative Group

BACKGROUND

A prospectively randomized trial was performed to compare the efficacy and toxicity of two chemotherapeutic regimens widely used in advanced non-small-cell lung cancer (NSCLC).

PATIENTS AND METHODS

From January 1989 to March 1992, 196 patients with measurable disease were included in the trial. Ninety-three patients received mitomycin-vindesine-cisplatin (MVP) and 94 mitomycin-ifosfamide-cisplatin (MIP).

RESULTS

The objective response rate (complete plus partial remissions) was 28% (26/93 patients, 95% confidence interval 20%-40%) in the MVP arm and 30% (28/94 patients, 95% confidence interval 20.5%-40%) in the MIP arm. The median survival was 8.5 and 9 months, respectively. Neither the response rates nor the median survivals were significantly different. Grade III-IV leukopenia was more frequent with MVP (13% vs. 2% of the courses, p < 0.001), as well as grade I-II neurologic toxicity (30% vs. 6%, p < 0.001). In contrast, grade I-II anemia and grade I-II urologic toxicity were more frequent with MIP (7% vs. 25%, p < 0.001 and 1% vs. 11%, respectively).

CONCLUSION

Given the low efficacy of both schemes in the treatment of advanced NSCLC, their use cannot be recommended outside of clinical trials.

[Phase II-III- study of cis-diaminodichloroplatinum (cisplatinum) (author's transl)]

A phase II-III study with cisplatinum alone or in combination was carried in 227 patients with advanced tumors. 21 received cisplatinum at 20 mg/mg2 daily five days. The other 206 patients received cisplatinum in different dosage and combination. In both groups of patients cisplatinum was given with hydratation and mannitol forced diuresis. There were 4 partial responders (19%) in the first group of patients and 117 responses (56,7%) in the other group with 43 complete responses in 35 germ cell tumors and 6 small cell lung cancer. Toxicity included 2 irreversible renal failure (0,8%), one in each group of patients. Clearance creatinine was below 50 ml/min before treatment in 22/227 (9,6%) of patients. Other toxic effects included gastrointestinal (100%) neurologic with paresthesias and electrophysiologic changes and hematologic suppression. We concluded that cisplatinum is a new effective agent in the treatment pf malignant diseases to be used every time in combination with other anticancer drugs.

Early clinical trial with quelamycin

Quelamycin (triferric doxorubicin) is a derivative of Adriamycin with different pharmacologic properties. Our phase I clinical study of quelamycin includes 37 patients with a wide spectrum of solid tumors. The recommended dose in good-risk patients is 150 mg/m2, given as a 1-hour infusion every 3 weeks. The dose-limiting factor appears to be myelosuppression, especially leukopenia. Other toxic effects include gastrointestinal intolerance and alopecia. Chills and fever are commonly encountered and might be due to an excess of free iron in currently available preparations. Cardiotoxicity could not be properly assessed. An objective antitumor effect was seen in patients with lung, gastric, colon, and ovarian carcinomas as well as osteogenic sarcoma. Further preclinical and clinical studies with an improved pharmaceutic formulation of the drug are highly desirable.