A randomized study comparing platinum, doxorubicin, and VP-16 with platinum, 4'-epidoxorubicin, and VP-16 in patients with non-small-cell lung cancer.

Forty-four previously untreated patients with advanced non-small-cell lung cancer were treated in a randomized trial comparing platinum (60 mg/m2), doxorubicin (40 mg/m2), and VP-16 (150 mg/m2) (PAV) with platinum (60 mg/m2), 4'-epidoxorubicin (50 mg/m2), and VP-16 (150 mg/m2) (PEV). The overall response rate was 10%. Major response rates were quite similar for the 21 patients treated with PAV (5%) and the 23 patients treated with PEV (18%) (p = 0.2). Of the 23 patients with assigned to PEV, two (9%) achieved complete responses for a median duration of 20 weeks and 44+ weeks. There was no significant difference (p = 0.75) in the median survival among patients treated with PAV (24 weeks) and those treated with PEV (20 weeks). Toxicity was generally mild and tolerable. The lack of response found in both arms of treatment caused the study to be terminated early. Some benefit could be appreciated in patients with limited disease and good Karnofsky performance status.

The role of combination cyclophosphamide, doxorubicin and cisplatin (CAP) chemotherapy in advanced non-small-cell lung cancer.

Thirty-one patients with non-small-cell lung cancer (NSCLC), stage III (T3 N2 M 0-1), were treated with cyclophosphamide (400 mg/m2), adriamycin (40 mg/m2) and cisplatin (60 mg/m2) (CAP) every 4 weeks for 8 cycles. Twenty-six patients were evaluable for response. Patients characteristics included: median age, 63 years; median performance status, 70% (range 60%-100%). One hundred and fifty-five cycles of chemotherapy were administered with a median of 5. There were 9 partial responses and 3 complete remissions, for an overall response rate of 46%. The median survival duration was 9 months, and 29% survived 1 year. CAP combination chemotherapy was well tolerated without nephrotoxicity, which can be imputed to the strong saline hydration given. Seventy percent of the patients did not experience emesis due to the antiemetic regimen used.

[HTLV-I in patients from Barcelona with connective tissue diseases, neurologic demyelinating diseases and lymphoproliferative syndromes]. / Investigación del HTLV-I en pacientes de Barcelona con conectivopatías, enfermedades neurológicas desmielinizantes y síndromes linfoproliferativos.

The presence of antibodies against HTLV-I was investigated with ELISA and Western blot techniques in 76 patients with lymphoproliferative syndromes (n = 53), idiopathic subacute myelopathies (n = 4), chronic T-lymphocytosis (n = 3) and collagen vascular diseases (n = 16) diagnosed in the Barcelona area. 9 HIV seropositive patients were included: 7 with lymphoma, 1 with chronic T-lymphocytosis and 1 with polymyositis. Although 3 samples were repeatedly positive with ELISA, none was confirmed with Western blot. These results suggest that in our country, contrasting with areas where HTLV-I infection is endemic, acute and chronic lymphoproliferative diseases, collagen vascular diseases and demyelinating neurologic diseases are not associated with HTLV-I infection. The development of lymphoma in patients seropositive for HIV also could not be related with HTLV-I infection.

[Primary infection caused by human immunodeficiency virus: clinical and serologic aspects of 7 cases]. / Primoinfección por el virus de la inmunodeficiencia humana: aspectos clínicos y serológicos de 7 casos.

We report 7 individuals in whom HIV seroconversion developed, in 6 associated with symptoms and in one without any symptom at all. The most florid and sustained symptoms appeared in the oldest patients: a female and her heterosexual partner, who was a promiscuous male with recent seroconversion. A heroin abuser had oral muguet, and another had esophageal candidiasis. Rash was absent in all cases. Antigenemia was demonstrated in 6 of the 7 patients. In one case, a third generation ELISA was more sensitive than Western blot for the identification of seroconversion.

[The evaluation of heterosexual transmission of the human immunodeficiency virus by nucleic acid amplification technics]. / Evaluación de la transmisión heterosexual del virus de la inmunodeficiencia humana por técnicas de amplificación de ácidos nucleicos.

Heterosexual couples of individuals infected by HIV represent a group of high risk of virus infection. We have investigated the presence of fragments of the HIV genome with a new nucleic acid amplification technique (PCR or polymerase chain reaction) in lymphocytes from 33 seronegative couples with anti-HIV antibodies, most of which were heroin addicts. 12 of the 33 couples (36%) had positive PCR for a gag HIV amplimer in the absence of antibodies. 4 of them (12%) also showed reactivity for sequences from an env amplimer. A control group of 7 patients with AIDS and 4 seropositive couples showed reactivity to gag and env in all. It is concluded that silent HIV infection may frequently develop in heterosexual couples of infected individuals.