[Chemotherapy of non-small cell bronchial cancers. Meta-analysis of the literature as a function of the extent of the disease]. / Chimiothérapie des cancers bronchiques non à petites cellules. Meta-analyse de la littérature en fonction de l'extension de la maladie.

A meta-analysis was carried out on the studies of chemotherapy of non small cell bronchial cancer published over the last fifteen years and this has demonstrated that the initial extent of the tumour was a significant prognostic factor in the response to treatment. A total of 6,247 patients were eligible for analysis: 1,435 with limited disease and 4,812 with disseminated disease. The objective and complete response levels for the overall group for those with limited disease and those with disseminated disease were respectively 25 and 3%, 34 and 5% and 22 and 3%. These differences were highly significant. The response level was significantly lower in cases of monotherapy when compared to combinations of cytostatic agents. In polychemotherapy, it was those combinations containing cisplatin, vindesine, vinblastine, mitomycin C and ifosfamide which were associated with the best results. An elevated dose of cisplatin (greater than or equal to 100 mg/m2) was also associated with a better response than those on the lower dose (less than or equal to 70 mg/m2). These differences were most clearly shown in those with limited disease.

Pharmacokinetics of repeated i.v. bolus administration of high doses of r-met-Hu interleukin-2 in advanced cancer patients.

We studied the pharmacokinetics of recombinant methionyl human interleukin-2 alanine (r-met-Hu IL-2 [ala 125]) given at high doses by i.v. bolus according to Rosenberg's initial schedule in seven patients with advanced cancer. Serum concentrations of IL-2 were measured by radio-immunoassay. The drug followed second-order kinetics. During the administration of repeated high doses of IL-2, we noted a progressive increase in the volume of distribution (from 5,984 +/- 1,850 to 9,084 +/- 4,345 ml) and a progressive decrease in the AUC (from 32,643 +/- 3,817 to 22,397 +/- 511 IU min ml-1) and beta-half-life (from 61 +/- 14 to 48 +/- 6 min); the peak serum IL-2 concentrations also decreased significantly. We attribute these findings to an expansion of the extracellular fluid space and an increase in the number of IL-2 target cells during the treatment.