Martin W. Oster

Ocular side effects of cancer chemotherapy.

The ocular side effects of cancer chemotherapeutic drugs are relatively uncommon. Patients with cancer may develop ocular problems due to metastases to the eye or central nervous system, side effects of radiotherapy or chemotherapy, or totally independent eye disorders. We present a review of the reported ocular toxicities of chemotherapeutic agents to assist the oncologist caring for such patients.

Kaposi's sarcoma following chemotherapy for testicular cancer in a homosexual man: Demonstration of cytomegalovirus RNA in sarcoma cells

A 35-year-old white Jewish homosexual man who had undergone surgery and chemotherapy for an embryonal carcinoma of the testis subsequently developed Kaposis sarcoma. The neoplasm involved the skin as well as visceral tissues. Tissue derived from a biopsy specimen of one of the skin lesions was used in the in situ hybridization technique for the detection of genetic material. Cytomegalovirus messenger RNA was identified in the neoplastic Kaposi cells in the skin. The significance of this finding is discussed.

Intratumor administration of beta‐interferon in recurrent malignant gliomas. A phase I clinical and laboratory study

We administered doses of 5 to 180 × 106 IU of beta‐serine‐interferon (IFN‐β ser17) twice weekly to 20 patients with recurrent malignant gliomas in a Phase I study. Interferon was given through an Ommaya reservoir connected by a catheter to the tumor cavity. Side effects of interferon therapy occurred in only one patient and consisted of nausea, vomiting, fever, and chills after each treatment, presumably due to rapid diffusion of interferon into ventricular cerebrospinal fluid (CSF). Problems with the Ommaya reservoir (obstruction in two patients and infection in four patients) led to six patients being terminated from the study, and represent the major difficulty with this form of therapy. Although this was primarily a study of interferon toxicity, of 12 evaluable patients, 3 had stable disease for 148, 192, and 539 days; 9 had progressive disease. In addition, we tested the effect of IFN‐β ser17 on the growth of early passage in vitro cultures of malignant gliomas established from patients. Growth inhibition varied from 0% to more than 50%. In all cultures evaluated, the combination of recombinant gamma‐interferon plus IFN‐β ser17 enhanced growth inhibition. Further clinical and laboratory study is necessary to better define the therapeutic efficacy of IFN‐β ser17 and the role of combinations of interferons in the treatment of malignant gliomas.

Diagnosis of primary breast carcinoma through immunohistochemical detection of antigen related to mouse mammary tumor virus in metastatic lesions: A report of two cases

Recent investigations have established that approximately half of human breast carcinomas contain an immunohistochemically detectable antigen which is cross‐reactive with the 52000‐dalton major glycoprotein (gp52) of the mouse mammary tumor virus (MMTV). This antigen can be localized in paraffin‐embedded sections of routinely fixed tissues using heterologous antibodies to gp52 or MMTV. This report describes two patients with metastatic carcinoma in axillary lymph nodes without any clinical evidence of a primary lesion in the breast or elsewhere. The localization of the gp52‐related antigen in paraffin‐embedded sections of both metastatic lesions suggested the presence of primary mammary carcinoma. In both instances, this suggestion was ultimately confirmed by the finding of primary lesions in which the gp52‐related antigen was also found.

Prostatic cancer with an unusual presentation: Polymyositis and mediastinal adenopathy

A 67‐year‐old man with prostate cancer presented with acute polymyositis and vocal cord paralysis as a result of mediastinal lymphadenopathy. His clinical course was unusual, with the development of a malignant pleural effusion, supraclavicular adenopathy, and osteolytic bone lesions. Urologic symptoms developed only pre‐terminally, and osteoblastic bone metastases were not documented. This case suggests that prostate cancer need not have a simple natural history.

Cytosine arabinoside and cisplatin for advanced breast cancer. A phase II study of the cancer and leukemia group B

Forty‐four women with advanced breast cancer participated in a prospective clinical trial to evaluate the efficacy and toxicity of a regimen consisting of cytosine arabinoside and cisplatin. All patients had previously received chemotherapy. Three patients (7%) responded to therapy with response durations of 153, 160, and 441 days. The median time to disease progression and median survival time in all 44 patients were 2.3 and 5 months, respectively. This regimen had significant toxicity, with most patients experiencing severe or life‐threatening hematologic, renal, or infectious complications. This regimen cannot be recommended for previously treated patients with advanced breast cancer.

Vincristine, adriamycin, and mitomycin (VAM) therapy for previously treated breast cancer: A preliminary report

Fifteen patients with metastatic breast cancer previously treated with chemotherapy were treated with a regimen consisting of vincristine, Adriamycin, and mitomycin. Eleven patients (73%) responded with three complete and eight partial responses. The median duration of response was eight months. While all four nonresponders died within five months, the median duration of survival of responders was 18 months. Toxicity was significant but tolerable. Thus, this preliminary report suggests that this regimen is active in advanced previously treated breast cancer, providing meaningful remissions with acceptable toxicity.

Pneumocystis pneumonia in a patient with cervical carcinoma treated with combination chemotherapy

Abstract A 62-year-old with metastatic cervical carcinoma being treated with combination chemotherapy developed diffuse pulmonary infiltrates. Bronchoscopic evaluation revealed pneumocystis pneumonia. She was successfully treated with trimethoprim-sulfamethoxazole. Gynecologists should be familiar with this opportunistic infection that can occur in patients receiving chemotherapy for gynecologic malignancies.

Medical Oncology in Journals of Internal Medicine

The coverage of medical oncology in internal medicine journals was evaluated by reviewing the contents of the 1974 and 1975 issues of three leading American internal medicine journals. The percentage of articles relevant to medical oncology compared favorably with figures for the other subspecialties of internal medicine. The subject matter of the medical oncology articles in the three journals was found to be complementary to the content spectrum of the subspecialty journal, Cancer. This distribution may be useful to the medical oncologist but may present a skewed view of recent developments in medical oncology to the nononcologist internist who relies largely on internal medicine journals for information regarding new trends in medical oncology. The implications of these findings are discussed, particularly with regard to the possibility that a similar situation exists for the other subspecialties of internal medicine.