Phase II study of a combination of low-dose cisplatin with 13-cis-retinoic acid and interferon-alpha in patients with advanced head and neck squamous cell carcinoma.

Preclinical and clinical data have suggested antitumor efficacy in squamous cell carcinoma (SCC) of interferon (IFN)-alpha and 13-cis-retinoic acid (13-c-RA) as single agent with greater activity in combination. Cisplatin was added to potentiate activity. Twenty-three patients with pretreated advanced or metastatic head and neck squamous cell carcinoma were given a combination of IFN-alpha (6 x 10(6) U/day, 84 days s.c.), 13-c-RA (1 mg/kg/day, 84 days) and cisplatin (40 mg/kg/day, day 1, 28 and 56). Seventeen patients had discontinuation of treatment and three patients received overall treatment without dose reduction. Hematological toxicity was more frequent; only three patients experiencing grade 3 or higher extra-hematological toxicity. Four out of 14 evaluable patients were in response, with one in complete pathological response. Median duration of response was 6 months with a 9 month median survival. Association of IFN-alpha, 13-c-RA and cisplatin induces modest but definite antitumor activity with moderate and manageable toxicity. Further studies of different combination modality therapy with chemotherapy and differentiating agents need to be performed in less pretreated patients.

[Asbestos and cancer of the larynx]. / Amiante et cancer du larynx.

Two hundred subjects were evaluated using a standardised questionnaire in order to determine possible exposure to asbestos: 50 patients with a carcinoma of the larynx (mean age: 59.2 +/- 1.6 years), 50 patients with a carcinoma of the bronchus (mean age 61.2 +/- 1.5 years) and 100 controls. Rates concerning exposure to asbestos were 27.8%, 23.4% and 4% respectively. The difference between the carcinoma patients and the controls was significant (p less than 0.001). The mean time lapse between the first exposure to asbestos and the development of malignant disease was shorter for the larynx (28.5 +/- 4 years) than for the lung (46.2 +/- 4.2): p less than 0.01. This study confirms the aetiological role of asbestos in the pathogenesis of carcinoma of the larynx as well as carcinoma of the lung, and raises the problem of their medicolegal compensation.

A randomized EORTC trial comparing intra-arterial infusion with methotrexate vs bleomycin as initial therapy in carcinoma of the oral cavity.

Either intra-arterial infusions of MTX (500 mg over 10 days) or intra-arterial infusions of BLM (95 mg over 13 days) were administered as initial treatment to 85 patients with untreated squamous cell carcinomas of the oral cavity. Tumour regression was assessed 10-15 days after the end of chemotherapy. A sequential analysis was used, and BLM demonstrated a significantly greater local efficacy after the 32nd matched pair was assessed. The same results were observed when tumour response rates were compared, ignoring the matching, on the 85 patients, (P less than 0.001). The response rate for patients with neck nodes was low (10/38). Catheter management problems, toxic effects and lethal reactions were 2.5 times more frequent in the MTX group.