Continuous intravenous infusion of vinca alkaloid using a subcutaneously implanted pump in a canine model

Hepatic intra-arterial infusion of vincristine

Currently the chemotherapeutic agents available for intra-arterial infusion in metastatic liver cancer are limited to only a few. The recent demonstration of the feasibility of prolonged IV infusion of vincristine led to exploration of hepatic intra-arterial infusion of this agent. A continuous infusion of 0.4 mg total dose was administered daily for 5 days via a hepatic artery catheter to each of six patients with metastatic liver cancer. Transient but life-threatening toxicity principally involving the nervous and gastrointestinal systems occurred in five of them. Future investigation of hepatic intra-arterial infusion of vincristine should be based on dose-schedules other than that employed in the current trial.

Treatment of advanced non-Hodgkin's lymphoma with vincristine infusion

Twenty-five patients with a variety of histologic types of advanced non-Hodgkin's lymphoma refractory to previous chemotherapy were entered into a trial of vincristine infusion. Patients received 5-day courses of vincristine 0.25 mg/m2/day by continuous intravenous infusion after an initial 0.5 mg intravenous bolus injection. Courses were repeated every 3 weeks. Objective responses were observed in nine patients (36%), all of whom had previously received vincristine given by conventional bolus injection. A complete response occurred in a patient with diffuse mixed histiocytic lymphocytic lymphoma, and partial responses were observed in eight patients with the following histologic types: diffuse poorly differentiated lymphocytic (4); nodular poorly differentiated lymphocytic (2); diffuse mixed histiocytic lymphocytic (1); and diffuse histiocytic (1). Duration of response lasted from 1.2 to 16.2 months (mean, 4.4 months). The principal complication of therapy was mild-to-moderate neurotoxicity; this occurred in 12 patients (48%) who received a total of 54 courses of vincristine infusion. Hematologic toxicity was minimal and nausea/vomiting did not occur. Vincristine infusion may afford palliation for patients with advanced non-Hodgkin's lymphomas who have become refractory to standard chemotherapeutic regimens even if they have received prior vincristine by conventional bolus injection. These data suggest the possibility of enhancing the therapeutic efficacy of vincristine in the treatment of non-Hodgkin's lymphoma by use of an infusion technique.