No abstract

Summary Fourteen patients with previously treated, locally advanced/metastatic transitional cell carcinoma (TCC) of the bladder or ureter received paclitaxel at a dose of 200 mg m-2 administered as a 3-h infusion every 21 days. The activity of paclitaxel in this group of patients was modest. The response rates were one partial response (PR) (7%) and three stable disease (SD). There were two early deaths.

The polymerase chain reaction to detect bcl-2-IgH rearrangements is presently carried out with widely disparate results. Further effort is required to bring forward a standard PCR protocol which can be re-tested in different laboratories to improve accuracy and reproducibility. The application of quantitative techniques such as real-time PCR may resolve many of the problems presently encountered.

Summary The combination of high-dose folinic acid with 5-fluorouracil has shown improved response rates in several trials in advanced colorectal carcinoma. This however is at the expense of increased toxicity: regimens using weekly bolus injections produce diarrhoea in most patients and occasional toxic deaths from this, whilst those using daily injections for one week in four report both diarrhoea and severe oral mucositis. Both types of regimen have significant rates of myelosuppression.A recent report described a different schedule of 5-fluorouracil and folinic acid, which appeared better tolerated but equally active (De Gramont et al., 1988 al., 1989). These reports also describe toxicity different from that produced by 5-fluorouracil alone: Regimens using weekly bolus injections are reported as frequently causing diarrhoea (in 22-80% of patients) with occasional toxic deaths from this (Petrelli et al., 1988;Petrelli et al., 1989), whilst those employing daily injections for one week in four report both diarrhoea and oral mucositis -the latter in 40-80% of patients (Machover et al., 1986;Erlichman et al., 1988;Poon et al., 1989

No abstract

Rituximab is active in MCL, and can induce complete responses in a minority of patients. Elevated LDH at the time of therapy, and prior therapy with alkylating agents, are associated with a significantly lower RR. The duration of response of one year is similar to that previously reported in follicular lymphoma.

No abstract

Sununa"r Twenty-nine patients with adenocarcinomas of gastrointestinal or unknown primarv, and three with advanced neuroendocrine tumours, were entered into a study of bolus plus infusional S-fluorouracil (FUra) modulated with high-dose leucovorin (LV) and recombinant interferon .2a (IFN-a). Successive cohorts of > 4 patients received IFN-a at 1.5. 3, 4.5. 6 and 9 MU on alternate days throughout the treatment period. The FUra LV regimen consisted of: LV 200 mg m i.v. infusion over 2 h. FUra 400 mg m' i.v. bolus then FUra 400 mg m-' i.v. infusion over 22 h, all repeated on day 2, on a 14-day cycle. FUra was given at 75% dose for the first course. increasing (in the absence of WHO grade > 2 toxicity) to 87.5% for the second and 100% for subsequent courses up to a maximum of 12. The maximum tolerated dose (MTD) of IFN-a was 6 MU on alternate days. with 7 8 patients at 9 MU requiring dose reductions. At 6 MU IFN-a. the MTD of FUra was not exceeded at 100% (i.e. 400mg m2 bolus and infusion. days 1 and 2). and FUra-related toxicities (mucosal, haematological, dermatological) were extremely mild. Twenty-nine patients were assessable for tumour response, among whom WHO criteria partial responses were seen in 7 14 with colorectal. 1 4 with gastric. 0 1 with pancreatic. 1 3 with neuroendocrine and 3 '6 with unknown primaries. Median response duration was 51 weeks. Minor responses and stable disease were seen in a further six patients. Median survival of patients with advanced adenocarcinomas was 9 months, with 33% surviving beyond 18 months. This schedule offers a safe way of co-administering FUra. LV and IFN-a. The addition of IFN-z. while causing significant independent toxicity, does not significantly increase the dose-limiting mucosal toxicities of FUra LV. Further investigation is required to determine the contribution of IFN-a to the anti-tumour activity of the combination.