Delbert M. Bergenstal

CHEMOTHERAPY OF ADRENOCORTICAL CANCER WITH o,p′DDD

Excerpt Our approach to the chemotherapy of adrenocortical carcinoma is based upon the original observations of Nelson and Woodard.1They observed that the oral administration to dogs of the insecti...

Therapy of Choriocarcinoma and Related Trophoblastic Tumors with Folic Acid and Purine Antagonists

TUMORS of trophoblastic origin may arise either in the uterus or in the gonads. They are characteristically highly malignant and spread rapidly both by direct extension and by metastasis to lungs a...

CHEMOTHERAPY OF CHORIOCARCINOMA AND RELATED TROPHOBLASTIC TUMORS IN WOMEN

Our initial experience in the treatment of choriocarcinoma and related trophoblastic tumors with the folic acid antagonist 4-amino-N10-methyl pteroylglutamic acid (methotrexate) has been reported previously.’, We shall now describe additional findings in 27 women whose therapeutic rcsponse to mcthotrexate has been observed over a period of two and onehalf years. Our rationalc in applying antifolic acid therapy in cases of malignant trophoblastic disease of women stems from earlier laboratory and clinical studies. The tissues of the female genital tract have a high requirement for folk acid that became apparent from experimental studies showing that., in the rat or monkey deficient in folic acid, the uterus is incapable of growth in response to administered e~trogens.~ Moreover, Nelson and Evans” demonstrated the high fetal requirement for folic acid in the rat. Indeed, Thiersch6 reported the induction of therapeutic abortion in women by the administration of aminopterin sodium, the folic acid antagonist. In addition, the clinical phenomenon of the macrocytic anemia of pregnancy, responding as it does to folic acid therapy, also appeared to reflect an especially high requirement for folic acid in the rapidly growing fetal and maternal tissues of pregnant women.6 Accordingly, we postulated that choriocarcinoma and related trophoblastic tumors that originated in the fetal chorion and initially involved the uterus might respond to treatment with folic acid antagonists.

Distribution of gonadotropic hormone activity in the serum proteins of normal pregnant women and patients with trophoblastic tumors

Abstract The gonadotropic activity of the sera of 12 pregnant women was shown, by zone electrophoresis and chromatography followed by paper electrophoresis, to be associated with the γ- and β-globulins, whereas the sera of 12 patients with gonadotropin-producing trophoblastic tumors showed hormone activity in the β- and α 2 -globulins. These findings suggest a difference between the serum chorionic gonadotropins of pregnant women and those of tumor patients.