Raltitrexed (tomudex) administration in patients failing multiple prior chemotherapy regimens in advanced colorectal cancer: a pilot study.

PURPOSE: To evaluate efficacy of Raltitrexed, a specific thymidilate synthase inhibitor, in patients with advanced colorectal cancer (ACC) failing multiple prior chemotherapy regimens (e.g. 5-FU+LV, CPT-11, etc). METHODS: 20 patients with ACC; 13 males/7 females, median age 64 (range: 53-69), median Karnovsky PS: 80 (70-90), and sites of metastases; liver: 16, lung: 6, lymph nodes: 9, peritoneal: 8 and a life expectancy of at least 3 months, were entered in the present pilot study of Raltitrexed administration. All patients had progressed after prior chemotherapy with 5-FU+LV and subsequently CPT-11, and some had received further infusional 5-FU, Raltitrexed was administered at a dose of 3 mg/m2 i.v. every 21 days. RESULTS: 3 patients obtained stable disease (SID), 15%, with tumor marker decline (CEA, CA-19.9). Time-to-progression was 4.8 months (2.2-7) and survival 7.4 months (6.0-7.8). Toxicity was in general not severe and consisted mainly of myelosuppression; neutropenia (WHO) grade 2: 45% and grade 3: 22%, and anemia grade 1-2: 40%. CONCLUSION: Response to treatment with Raltitrexed is limited in patients with ACC failing multiple prior chemotherapy regimens, however, a limited percentage of patients with SD derived clinical benefit.

Lactobacillus rhamnosus endocarditis complicating colonoscopy.

We report the first case of endocarditis caused by Lactobacillus after an uneventful colonoscopy. The initial empiric treatment with the standard regimen of penicillin-aminoglycoside failed; subsequent treatment with a combination of antibiotics, selected according to the in vitro studies, was successful.

Ondansentron and dexamethasone treatment with different dosing schedules (24 versus 32 mg) in patients with non-small-cell lung cancer under cisplatin-based chemotherapy: a randomized study.

The purpose of this study was to determine whether ondansentron given to patients with non-small-cell lung cancer (NSCLC) undergoing cisplatin-based chemotherapy, has better antiemetic activity administered every 6 or 8 h in controlling cisplatin-induced emesis. All patients had previously received 3 cycles of cisplatin-based chemotherapy at a dose of 100 mg/m(2). Ondansentron was given according to two schedules in group A (50 patients) at a dose of 8 mg in 100 ml normal saline over 10 min i.v. infusion, together with dexamethasone 8 mg before the infusion of cisplatin, continued with both drugs at the same dose and administration after 8 and 16 h; in group B (50 patients) both drugs were administered before the infusion of cisplatin, continued after 6, 12 and 18 h. During the next 3 days, patients continued with tablets of dexamethasone 4 mg and ondansentron 8 mg, group A every 8 h, and group B every 6 h. The only difference in terms of antiemetic response that was noticed between the two groups was the number of patients experiencing nausea which was found increased in group A (n = 32) in comparison to group B (n = 25) (p < 0.022). No difference was noticed in the number of vomiting episodes and retches or emesis control, during the 3-day evaluation period after cisplatin infusion or in side effects. In conclusion, the total dose of 24 mg ondansentron during the acute phase of emesis is as effective as the total dose of 32 mg.