Thirty‐one patients with metastatic cancer were treated with cis‐diamminedichloroplatinum (II), CACP, in dosages ranging from 7.5 to 200 mg/m2 BSA per course. Twenty‐two patients received more than one course. Toxicity to the initial course of CACP, up to 90 mg/m2 BSA, was minimal and transient in most patients. At higher dosage levels or following repeat courses, the drug‐related toxicity was more severe. Drug‐related toxicity was more severe in patients with abnormal excretory tracts. The most common and earliest side effects were nausea and vomiting. Hyperuricemia commonly occurred shortly after administration of CACP. A dosage‐dependent, generally transient, nephrotoxicity was noted within the first 10 days after a course of CACP. Moderate leukopenia and thrombocytopenia, as well as a progressive normocytic anemia with marrow erythroid hypoplasia, were observed as late as 3 to 4 weeks after injection of this agent. Audiologic impairment above the frequency range of normal speech was detected by audiometry. Objective tumor regression was seen in five patients, four of whom experienced moderate‐to‐severe toxicity.
An experience with Mithramycin in the treatment of hypercalcemia of malignancy is reported. Mithramycin given by direct, single, intravenous injection of 25 μg/kg was effective in lowering serum calciums within 24 to 48 hours in the majority of patients studied. The duration of this effect has been quite variable, but repeated doses of single injections have proven to be successful in most cases treated. The potential clinical usefulness of this agent in the treatment of hypercalcemia is apparent. It is reasonable to continue such studies on a long‐term basis. Such studies are currently in progress.
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