Gemcitabine in brief versus prolonged low-dose infusion, both combined with carboplatin for advanced non-small cell lung cancer.

PURPOSE: Gemcitabine in low-dose prolonged infusion is a treatment with documented activity against a variety of tumors. The present study was conducted to evaluate the efficacy and safety of the combination of gemcitabine at a low-dose prolonged infusion in comparison with standard dose gemcitabine with carboplatin in chemonaive patients with advanced non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Sixty chemonaive patients with stage IIIB or IV NSCLC were included. Patients were randomly assigned 1:1 to receive 350 mg/m 2 gemcitabine in a 6-h infusion on days 1 and 8 and carboplatin area under the serum concentration time curve (AUC) 5 on day 1 versus gemcitabine 1,000 mg/m 2 on days 1 and 8 and carboplatin AUC 5 on day 1 (3-week cycle both). A total of 118 chemotherapy cycles, with a median of 4 cycles per patient (range 2-6), and 134 chemotherapy cycles, with a median of 4.47 cycles per patient (range 3-6) were administered in standard and low infusional dose arm, respectively. RESULTS: Among patients in the standard arm, 40% had overall response rate (ORR), 33.3% had stable disease and 26.6% had progressive disease, while in low-dose infusional arm, 36.6% had ORR, 36.3% had stable disease and 26.6% had progressive disease (P = 0.992). Median progression-free survival was 5.5 months and 5.4 months, median overall survival was 9.7 months and 10.7 months, and 1-year survival was 33.7% and 36.6% in standard arm and low-dose infusion arm, respectively. Grade 3/4 toxicity was rare. CONCLUSION: In NSCLC, gemcitabine low-dose prolonged infusion with carboplatin has low toxicity, especially thrombocytopenia, and has an activity comparable with gemcitabine given in higher dose in standard infusion.

Clinical application of serum levels of sialic acid, fucose and seromucoid fraction as tumour markers in human leukemias.

To establish a blood-based biochemical profile for diagnosis and management of human leukemias, serum total sialic acid/total protein, lipid bound sialic acid, fucose/total protein and seromucoid fraction (quantitated as its hexoses and protein contents) levels were measured by highly specific spectrophotometric methods. Compared to the controls (n = 150), all the biomarkers were significantly elevated in anemia patients (pathological controls, n = 77) and untreated leukemia patients (n = 145). Furthermore, significantly raised levels of the markers were observed in untreated leukemia patients compared to anemia patients. Fucose/total protein was the most specific (71.0%) marker, while hexose levels were the most sensitive (93.0%) marker for leukemia. The levels of the biomarkers in patients with persistent leukemic activity/accelerated leukemic phase were significantly higher than those in patients in remission and were comparable with pretreatment levels. The study suggested that the markers evaluated are useful in diagnosis and treatment monitoring of leukemia patients.

Recombinant alpha-interferon therapy in multiple myeloma.

Three patients with multiple myeloma were treated with recombinant alpha-interferon (r IFN-alpha 2b Intron AR) along with combination chemotherapy i.e. melphelan and prednisolone. In one case it was given as an initial therapy, while the other two patients had refractory and relapsing disease respectively. IFN-alpha 2b was given in the dose of 2 x 10(6) Mu/m2 by subcutaneous injection thrice in a week for six months in two patients and for three months in one patient. All three patients experienced improvement in bone pains; partial response with reduction in the paraprotein level was seen in one patient; while there was no radiological, biochemical or haematological improvement in two patients. Side effects noted were flu like syndrome in all three patients and urticaria in one patient. They were treated symptomatically and did not require cessation of interferon therapy.