The fifth Myron Karon Memorial Lecture. The cure of cancer by chemotherapy - reflections on how it happened

The successful integration of research and care: how pediatric oncology became the subspecialty in which research defines the standard of care

Pediatric oncology successfully embodies the integration of patient care with medical research. Several factors may explain this phenomenon. Specifically, the study of childhood leukemia provided scientists with principles by which they could approach other forms of cancer. Multicenter, cooperative group RCTs resulted in meaningful advances. Parents' often desperate hope for a cure, combined with clinician-investigators efforts to continually improve upon treatments resulted in important improvements in children's lives. Finally, the seemingly tolerant regulatory oversight of human subjects research in the early years of childhood cancer research paradoxically helped link research with care, thus solidifying this bond for years to come.

Roy Hertz, M.D. (1909-2002): the cure of choriocarcinoma and its impact on the development of chemotherapy for cancer

Dr. Roy Hertz is one of two scientists credited with discovering the first medical cure of a solid cancer. This paper presents a biographical history of Dr. Hertz and discusses his roles in the discovery of a cure for choriocarcinoma and as a pioneer for future research in cancer chemotherapy. This biography not only serves as a testament to the pioneering individuals in the field of chemotherapeutics but also represents the unique blend of medical, pharmacological, and physiological histories that led to the profound discovery. The timing and significance of the work of Drs. Hertz and Li cannot be overestimated. Their discovery was a spectacular success, demonstrating proof of the principle that chemotherapy can cure metastatic cancer and that an almost uniformly fatal cancer in young patients could be cured with a single chemotherapeutic agent, which stands as one of the greatest achievements in cancer research.

Comparative nephrotoxicity of carboplatin and cisplatin in combination with tobramycin

The nephrotoxic potentials of cisplatin and carboplatin, alone and in combination with the aminoglycoside antibiotic tobramycin, were compared in male rats. Sixty (60) male Sprague-Dawley rats were divided into six groups of ten rats each and received the following treatments: Group I, saline; group II, cisplatin (5 mg/kg); group III, cisplatin (5 mg/kg) + tobramycin (50 mg/kg); group IV, carboplatin alone (50 mg/kg); group V, carboplatin (50 mg/kg) + tobramycin (50 mg/kg); and group VI, tobramycin alone (50 mg/kg). Carboplatin and cisplatin were each administered as a single i.v. injection on day 1. Tobramycin was administered i.-m. once daily on days 1-5. All rats were euthanatized on day 6. Smaller body weight gains occurred in groups II-V than in saline controls. Serum urea nitrogen (BUN) levels recorded on day 6 were elevated in group III. BUN values of all other groups were normal. Histopathologic examination of kidneys revealed acute tubular injury in rats treated with cisplatin, whether alone or in combination with tobramycin, and in carboplatin/tobramycin-treated rats. Carboplatin and tobramycin, when administered separately, were not nephrotoxic. The combination of cisplatin and tobramycin proved to be the most nephrotoxic treatment.

The effect of food and concurrent chemotherapy on the bioavailability of oral etoposide

There is no information on the effect of food or concurrent drug administration on the bioavailability of oral etoposide, despite the fact that treatment is frequently administered over several days and most often in combination with other cytotoxic agents. The influence of these factors has been studied in 11 patients, receiving combination cytotoxic therapy for extensive small cell lung carcinoma. Neither food nor concurrent oral or intravenous chemotherapy had a significant effect on the mean plasma concentrations of etoposide, achieved following oral administration. Wide variation in peak plasma concentrations and in area under the concentration time curve (AUC) occurred both between and within patients. It appears unnecessary for patients receiving etoposide (at 100 mg) to fast prior to drug administration. Furthermore, oral etoposide (at 100 mg and at 400 mg) may be given in combination with other cytotoxic agents without compromising its bioavailability.