David C. Stolinsky

Streptozotocin in the treatment of cancer: phase II study.

Streptozotocin (NSC‐85998) was administered to 53 patients at a dose of 1 to 2 g/m2 weekly. Response to therapy could be evaluated in 39 patients. Responses exceeding 50% in magnitude of tumor reduction were noted in three patients; responses of 25–50% were noted in an additional four patients. Responses were noted in two of four patients with islet cell carcinoma, one of four patients with malignant carcinoid, one of two patients with carcinoma of the lung, one of two patients with squamous carcinoma of the oral cavity, one patient with synovial sarcoma, and one patient with adenocarcinoma of the gallbladder. Renal toxicity was manifested by azotemia in 21 patients and by proteinuria in 28 patients. Elevation of serum glucose occurred in seven patients, but clinical diabetes did not develop. Nausea and vomiting occurred in 40 patients. Hematologic toxicity was noted in four patients.

clinical experience with procarbazine in Hodgkin's disease, reticulum cell sarcoma, and lymphosarcoma

Seventy‐two patients with Hodgkins diseasereticulum cell sarcomalymphosarcomaand various other malignant neoplasms were treated with the methylhydrazine derivative procarbazine hydrochloride (Matulane, NSC‐77213). Response to therapy could be evaluated in 50 patients. Favorable responses occurred in 22 of 33 evaluable patients with Hodgkins disease2 of 5 patients with reticulum cell sarcomaand 2 of 5 patients with lymphosarcoma. All of the responders had previously shown resistance to at least 2 other antitumor agents. Toxic effects of therapy included leukopeniathrombocytopenianauseavomitingstomatitislethargyataxiaand alopecia. Median time to start of response was 21 days; median cumulative dose to start of response was 51.3 mg/kg. Responses lasted a median of 98 days (range: 34‐322 days). Procarbazine is a useful agent in advanced lymphomas.

Hexamethylmelamine (NSC-13875) alone and in combination with 5-(3, 3-dimethyl-triazeno) imidazole-4-carboxamide (NSC-45388) in the treatment of advanced cancer

Hexamethylmelamine (HMM) was administered by mouth to 115 patients; 108 were eligible for the study and were evaluated for toxicity, while 82 completed one 21‐day course and were evaluated for response. Responses exceeding 50% in tumor reduction were observed in 1 of 41 evaluable patients (2%) with lung carcinoma and in 4 of 10 with squamous carcinoma of the cervix. HMM was also given in combination with NSC‐45388 (ICDT) to 30 patients; 27 were eligible for the study and were evaluated for toxicity, while 25 completed one 21‐day course and were evaluated for response. Responses exceeding 50% were obtained in 2 of 16 evaluable patients with melanoma and in none of 5 patients with lung carcinoma. Toxic effects of therapy included nausea and vomiting, leukopenia, thrombocytopenia, anemia, and both central and peripheral nervous system manifestations. Further study of HMM in carcinoma of the cervix would be of interest. Further trial of combined HMM and ICDT was abandoned because of the nausea encountered.

Prolonged survival after cerebral metastasis of testicular carcinoma

A 30‐year‐old man underwent orchiectomy in 1962 for a testicular carcinoma composed of choriocarcinomatous and teratocarcinomatous elements. Bilateral pulmonary metastases regressed completely on combination chemotherapy. However, a cerebral metastasis developed in 1963 and caused severe neurologic signs. At craniotomy a large mass of choriocarcinomatous tissue was incompletely removed. Further chemotherapy resulted in a complete remission. The patient remains free of disease more than 16 years later. The treatment of cerebral metastasis is discussed, with emphasis on the possibility of long‐term survival and the role of surgery. Cancer 47:978–981, 1981.

Trial of 1-(2-Chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU; NSC-79037) in Advanced Bronchogenic Carcinoma

A total of 103 patients with lung cancer was treated with CCNU 130 mg/m2 orally every 6 weeks; 65 patients survived at least 6 weeks. Partial responses occurred in 7 patients. Leukopenia, thrombocytopenia, and nausea were frequent toxic effects. CCNU has slight efficacy in advanced lung cancer. No increase in survival was attributed to therapy.

Results with CCNU in Resistant Hodgkin’s and Non-Hodgkin’s Lymphoma

72 patients with advanced malignant lymphoma resistant to standard chemotherapy were treated with 1-(2-chloroethyl)-3-cyclohexyl-l-nitrosourea (CCNU) at 130 mg/m2 orally every six weeks. Objective responses were noted in 13 of 39 evaluable patients with Hodgkins disease, three of 15 patients with lymphocytic lymphoma, and one of seven patients with histiocytic lymphoma. Responses lasted one to 22 months (median: four months) and occurred in patients whose disease was resistant to alkylating agents, vinblastine, vincristine, corticosteroids, procarbazine, and bleomycin. Leukopenia and thrombocytopenia were frequent toxic effects of therapy.

Rotational Therapy with a Colchicine Analog in Chronic Granulocytic Leukemia

9 patients with chronic granulocytic leukemia were treated sequentially with busulfan, 6-mercaptopurine, and trimethylcolchicinic acid methyl ether d-tartrate (TMCA; NSC-36354). Smoothness of control of the disease was similar with busulfan and 6-mercaptopurine, but it was significantly poorer with TMCA. Toxic effects of therapy and median survival were similar to those observed with conventional therapy.