Albert H. Owens

Appraisal of methods for the study of chemotherapy of cancer in man: Comparative therapeutic trial of nitrogen mustard and triethylene thiophosphoramide

Abstract Suggestions are made for the conduct of chemotherapy trials in patients with cancer. Application of the principles involved are illustrated in a comparative study of triethylene thiophosphoramide and nitrogen mustard in cancer of the lung and breast, melanoma, and Hodgkins disease. Neither drug was appreciably effective in cancer of the lung which had previously been irradiated or in melanoma. In cancer of the lung not previously irradiated and in cancer of the breast, 30 to 50 per cent reduction in tumor size occurred in 10 to 26 per cent of the patients. In Hodgkins disease certain factors limit the completeness of the comparison, but it is possible to draw the tentative conclusion that thio-TEPA was less active than HN2 (in the doses used) in inducing remissions. The advantages and disadvantages of this type of trial are discussed and several suggestions are made for improved experimental design.

Comparative trial of chemotherapy and radiotherapy in patients with non-resectable cancer of the lung☆

Abstract Two hundred and nineteen patients with carcinoma of the lung were studied in three treatment groups in a cooperative in-hospital study. Of these patients, 196 had not received prior therapy. Treatment group I was given a mean of 3,843 tissue r., treatment group II a mean of 37.8 mg. of nitrogen mustard therapy and 3,658 tissue r. simultaneously and treatment group III 41.0 mg. nitrogen mustard therapy followed by 3,633 tissue r. In evaluating shrinkage in tumor size, benefits as determined by votes of the investigators and over-all survival curves, essentially no beneficial differences emerged for any one treatment group. Toxicity was slightly greater in group II, and treatment time extended for these same patients. No difference in toxicity or survival time appeared between 250 kv. or 2 Mev radiotherapy equipment. Data and discussion are presented to indicate that in this study survival time is independent of the form of treatment administered but that natural selection alone determines the patients with longer survivorship. The routine use of radiotherapy and mechlorethamine treatment, therefore, is questioned.

Training Program in Medical Oncology

Abstract Medical oncology has been established as a new subspecialty of internal medicine. To define the scope of training programs in medical oncology, proposals have been made to aid in establish...

Combination chemotherapy of the malignant lymphomas. A Controlled clinical trial

The Eastern Cooperative Oncology Group has studied 113 patients with generalized progressive malignant lymphomas in a randomized clinical trial. Pathologic diagnosis was subclassified by cell type and nodal pattern by The Pathology Panel for Lymphoma Clinical Trials. Patients were randomly assigned treatment with either cyclophosphamide (C), vincristine (O), and prednisone (P) (COP) or CO without prednisone. Initial treatment was given for 8 weeks and further randomization of responders to observation or additional chemotherapy was carried out. A significant difference in complete remission rate between treatments was shown: with COP, 43%, and with CO, 17%, indicating an important role for prednisone in inducing CR. COP was also associated with longer remission durations and improved survival. Complete remission following initial chemotherapy is also associated with longer duration of disease‐free time and survival. The initial pathologic cell types and nodal pattern also strongly influence survival. Extended “maintainence” CO treatment improved disease‐free remission duration, but not survival.

Rate of metabolism of ethyl alcohol in the mouse.

Summary The rate of oxidation of alcohol has been studied in the mouse by determination of the rate of decline of the concentration of alcohol in the blood as well as by determination of the alcohol content of the whole animal at various times after administration of the drug. When observations are begun one hour after administration of alcohol, the rate of oxidation is constant and independent of the amount present. However, the rate of oxidation may be twice as great in the first hour as in subsequent hours. The effect is dependent on dose and to some extent on mode of administration.

A comparative study of optimal medical care with and without azaserine in multiple myeloma.

A comparative clinical study of optimal medical care plus azaserine versus optimal medical care plus a placebo was accomplished in 20 patients with multiple myeloma. Azaserine was originally studied in myeloma because of reported effects on a plasma cell neoplasm in mice. The controlled study was undertaken because suggestive activity in myeloma had previously been seen. The 9 azaserine‐treated patients sustained more toxicity than the 11 placebo‐treated patients. No important difference in tumor behavior was detectable between the azaserine and placebo‐treated groups as determined by physical examination or the several hematologic, biochemical, and roentgenologic measurements made.