Multicenter Phase II trial of intermediate dose cisplatin and vinorelbine in inoperable non-small cell lung cancer patients.

Vinorelbine (VNB) and cisplatin (CDDP) combination regimen was found active in the treatment of advanced non-small cell lung cancer (NSCLC) patients, but significant toxicity was observed. We evaluated the activity and toxicity of this combination administered at lower doses than previously reported. From March 1992 to March 1994, 99 patients (pts) were enrolled in a multicentric Phase II study and received intravenous CDDP at 80 mg/m2 on day 1, associated with intravenous VNB at 25 mg/m2 on days 1 and 8. Cycles were repeated every 3 weeks. The reduced doses led to a consistently lower myelotoxicity (8% Grade III-IV leukopenia) in comparison to two related Phase III studies, recently published. Conversely, the incidence of neurological toxicity was superimposable. Considering all eligible patients, the overall response rate was 28.3%, and this is similar to the results commonly observed employing the most active CDDP containing regimens. In conclusion, CDDP and VNB combination chemotherapy at the schedule performed in the present study led to a reduction of hematologic toxicity, while an appreciable activity was maintained.

Right ventricular metastasis from choriocarcinoma: report of a rare case and review of the literature.

A previously healthy gravida developed chest pain and progressive dyspnea several months after delivery. A right ventricular mass rising from the septum and floating through the pulmonary valve was detected, with multiple lung nodules. With the suspicion of a primary sarcoma of the heart, she was referred for cardiac surgery. Microscopic observation of the cardiac neoplasm revealed malignant trophoblast. There was no evidence of disease in the uterus and adnexa. Combination chemotherapy with EMA-CO schedule was instituted because of the high-risk score. A complete recovery was achieved after 20 weeks of treatment and the patient is free of disease 4 years after the end of chemotherapy and is now pregnant again.