Gemcitabine and cisplatin in the treatment of advanced non-small cell lung cancer: national cancer institute Cairo experience

The aim of the present study is to document the antitumor activity of the combination of gemcitabine and cisplatin for the treatment of advanced NSCLC, assess the nature and severity of the side effects and elicit the impact of the combination chemotherapy on progression free survival and overall survival. From August 1997 to August 2001 we conducted a phase II study of gemcitabine and cisplatin in 60 chemonaive patients [21 stage IIIB and 39 stage IV]. For the first 34 cases, gemcitabine was given at a dose of 1,000 mg/m[2] IV on days 1, 8 and 15 with cisplatin 100 mg/m[2] on day 15, every 28 days. In the following 26 patients, the regimen was modified to gemcitabine 1,250 mg/m[2] days 1 and 8 and cisplatin 80 mg/m[2] day 1, every 21 days. Patients included 53 males and 7 females [median age. 52 years [range, 28-69]]. Twenty-nine had adenocarcinoma, 18 large-cell carcinoma and 13 squamous-cell carcinoma. Thirty-one patients had a performance status [PS] of 2 and 22 presented with weight loss. All patients were evaluable for response. Three patients achieved a complete response [CR] and 22 had partial response [PR], giving an overall response of 41.7%, with a median duration of 10 months [range, 4-46 months]. The time to progression [TTP] was 8 months [range, 2-46 months], with a median overall survival of 9 months [range, 2-46 months]. The one-year survival rate was 30.3% for the entire study population, 44% for responders, and statistically improved in patients with a PS of 1 and those with no weight loss. A total of 255 cycles were administered [median, four cycles/patient]. Myelosuppresion was significant [but manageable] with grade 3/4 neutropenia in 32.6% of cases, anemia in 18.6% and thrombocytopenia in 20.4%, Nonhematologic toxicity was limited to grade 3/4 nausea and vomiting in 28.8% of cases and impaired liver enzymes in 13.6%. Inspite of the relatively poor prognostic characteristics in the study population, gemcitabine and cisplatin was an effective combination with tolerable, manageable toxicity in advanced NSCLC

Mitoxantrone in advanced breast cancer

Twenty-six untreated patients with advanced or metastatic carcinoma of the breast were treated by a combination of mitoxantrone. Fluorouracil and cyclophosphamide. The mean age was 48 years [range 30-65]. Eight patients were premenopausal and 18 postmenopausal. All patients had a performance status >70 according to the Karpofsky scale. Toxicity was tolerable during the 162 treatment cycles. Leucopenia [2-1 x 103] was observed in 40% of patients between the first and second week post chemotherapy. Thrombocytopenia [<100.00/mm3] was noted in two patients only. Mild alopecia was observed in 69% of patients. Nausea and vomiting occurred during 74.7% of the treatment cycles [121/162]. Two patients developed reduction in the ventricular ejection fraction before the maximum allowed dose but without clinical evidence of cardiac failure. Of the 25 evaluable patients 13 [52%] responded with achievement of complete remission in seven patients [28%]. The two years actuarial survival rate was 35%. Mitoxantrone combination chemotherapy is an effective regimen in advanced breast cancer with less toxicity

Combined treatment modalities for advanced Hodgkin's disease: a ten years follow-up

Twenty patients [Pt] with advanced Hodgkin's disease were treated by combination chemotherapy [MOP-BAP]: Nitrogen mustard 6 mg/m2 i.v. day 1, vincristine 1.4 mg/m2 i.v. days 1 and 8, procarbazin 100 mg/m2 o. days 2-7, and 9-12 with prednisone 40 mg/m2 cycle one and four, adriamycin 30 mg/m2 i.v. day 8 and bleomycin 2 mg/m2 i.v. days 1 and 8. All patients received 6 cycles as induction therapy. Patients in PR received low dose of radiation 20-25 Gy to involved fields. The age ranged between 20-64 years [mean 34.4 years]. Clinical stages were IIIA [6], IIIB [6], IVB [8]. Most of the patients had bulky disease [75%], and 85% had more than three sites of involvement by the disease. Pathological types: Mixed cellularity [11], nodular sclerosis [5] and lymphocytic predominance [4 patients]. According to the study protocol 6 patients in PR had received involved field radiotherapy, four of them had achieved complete remission, two patients had increased disease and death. Ten of the study group [56%] are still alive after 121 months of initial therapy, toxicity was observed with radiotherapy