Adriamycin as a Single Agent in Various Forms of Advanced Neoplasia of Adults and Children

Adriamycin plus Cyclophosphamide in Advanced Bronchial Carcinoma

Adriamycin (40 mg/m2 i.v., on day 1) plus cyclophosphamide (200 mg/m2 orally, day 1 to 5) were given to 23 patients with advanced lung cancer. Administration cycles were repeated every 3 weeks. No patient had been previously treated with chemotherapy, 5 received prior radiotherapy. Objective improvement was observed in 7 patients, partial remission was observed in 3. The median duration of response was 2 months.

SARC-CTOS imaging symposium: introduction to the problem from a clinical perspective

Failure to correctly design clinical trials precludes effective evaluation of yield data. For instance, the Response Evaluation Criteria in Solid Tumors were developed using unidimensional measurements, while the World Health Organization criteria were based on bidimensional measurements. Attempts to compare data from the two response criteria have been problematic. There is an ongoing debate regarding the definition of what constitutes response, and there is a need to update the existing criteria. Advances in imaging techniques need to be evaluated and added into new response criteria. As sarcoma patients can derive clinical benefit from therapy without sizable tumor shrinkage, identifying other qualitative changes, such as ossification of osteosarcomas, should also be incorporated into new response criteria. This article reviews existing approaches to assess response criteria in sarcomas, and explores the role of modern imaging in the evaluation of clinical benefit.

Ocular adverse reactions associated with adriamycin (doxorubicin)

To assess the ocular safety of doxorubicin, we reviewed doxorubicin-associated ocular adverse reactions reported to Adria Laboratories or published in the clinical literature. Conjunctivitis was the most frequently reported reaction. Periorbital edema was reported in two patients, and lacrimation was reported in a published study. Blepharospasm, keratitis, and decreased visual acuity were reported once each in patients treated with combination chemotherapeutic regimens containing doxorubicin. These reactions usually resolved rapidly on discontinuation of the drug. Conjunctivitis frequently followed accidental ocular exposure to doxorubicin. All but a few of these reactions cleared within 24 hours of exposure. The infrequent nature and usually rapid resolution of these ocular adverse reactions suggest that when ocular toxicities occur in patients undergoing doxorubicin-containing chemotherapy, the cautious reintroduction of doxorubicin, if further antineoplastic therapy is indicated, should be considered.

In vitro evaluation of cisplatin interaction with doxorubicin or 4-hydroperoxycyclophosphamide against human gynecologic cancer cell lines

Doxorubicin, cisplatin, and cyclophosphamide are the three drugs most commonly used in the treatment of ovarian cancer, but no effect greater than additivity was observed for any combination of these drugs in the present study. Only a few studies have been reported concerning the degree of their additivity or their best order of sequencing. In our in vitro studies, cisplatin in combination with doxorubicin or 4-hydroperoxycyclophosphamide (4HC) was tested against seven human gynecologic tumor-cell lines in different sequences, using a double-agar layer tissue-culture system. Drug interactions with respect to inhibition of tumor clonogenicity were evaluated by isobologram and fractional survival methods. Doxorubicin and 4HC were sequenced simultaneously and at 1, 6 and 24 h after cisplatin, and cisplatin was sequenced at 1, 6 and 24 h after 4HC. The isobolograms constructed for doxorubicin or 4HC plus cisplatin revealed strict additivity between these agents against ovarian cancer clonogenicity. Both doxorubicin and 4HC showed the greatest additivity when used simultaneously and at 1 h vs 6 or 24 h after cisplatin. Although the mechanisms by which these sequencing effects occur are unknown, these studies provide new leads for the design of clinical trials with combinations of these three agents.

High-performance liquid chromatography and thin-layer chromatography of anthracycline antibiotics: separation and identification of components of the dauno-rubicin complex from fermentation broth

A new solvent system composed of methanol-acidic water (pH 2.0 with phosphoric acid) has been developed for high-performance liquid chromatography of the daunorubicin complex from fermentation broth on a micro Bondapak C18 column. Application of this solvent system in conjunction with thin-layer chromatography in the identification of anthracycline antibiotics from the fermentation broth is discussed.

Adriamycin in advanced urinary tract cancer: experience in 42 patients and review of the literature

Forty-two patients with measureable, advanced, genito-urinary cancer received Adriamycin. Significant clinical responses (CR/PR) occurred in only five (14%) of 35 adequately treated patients. Four additional patients achieved a minimal response anf four others showed stabilization of their disease for 4 to 9 months. Review of the literature suggests an overall response rate of 20%. Patients with a urinary diversion lived significantly longer (P 0.006) than patients who did not have this procedure (42.5 months vs 21.5 months). The need to define various patient characteristics in future chemotherapeutic trials in bladder cancer is discussed.