[Chemotherapy of advanced ovarian carcinoma. II. Second-line treatment and new therapeutic modalities]. / Chemioterapia del carcinoma ovarico avanzato. Parte II.--Trattamento di seconda istanza, nuove modalità terapeutiche.

Despite the efficacy of cisplatin-containing regimens the majority of patients with advanced ovarian cancer will die of their disease because of its high recurrence rate. Salvage therapy, generally with cisplatin alone or in combination, is still discouraging. Among the drugs recently tried against this disease, mitoxantrone, ifosfamide and etoposide warrant further investigation because of their ability to induce responses in cisplatin refractory patients. While epirubicin, due to its lesser cardiotoxicity, can replace the parent compound, the exact role of cisplatin analogues is still controversial because their different toxicity does not necessarily imply a better therapeutic index. Intraperitoneal therapy is emerging as a new treatment effective in selected cases. Encouraging preliminary results have been reported with some biological response modifiers, such as interferons, interleukins and monoclonal antibodies. It is likely that in the near future information gained by both basic and clinical research will improve the prognosis of patients with ovarian carcinoma.

[Current results and prospects of intra-arterial chemotherapy in hepatic metastases of carcinoma of the colorectum]. / Risultati attuali e prospettive della chemioterapia intra-arteriosa delle metastasi epatiche da carcinoma del colon-retto.

The development of safe arterial access devices and totally implantable or portable infusion pumps for intrahepatic chemotherapy has generated a renewed interest in regional treatment of liver metastases from colo-rectal primaries. Several phase II trials have been carried out, mostly using prolonged infusion of fluorinated pyrimidines showing very high activity for this method of treatment with response rates up to 80%. Randomized trials between systemic and regional therapy have confirmed the higher efficacy of arterial treatment in inducing objective responses but neither of the two studies with a follow-up long enough to assess survival data showed a clear advantage for the patients receiving intraarterial chemotherapy. Gastroduodenitis, ulcers and chemical hepatitis are frequently observed in patients treated with intrahepatic arterial chemotherapy but their incidence can be substantially reduced by a careful surgical procedure during the implant of the arterial catheter and by a close follow-up during chemotherapy. Since toxicity can be serious and no definitive improvement of survival has been shown, this modality of treatment is still applicable only in an investigational setting.

[Aztreonam and oxacillin in the treatment of febrile neutropenic patients with solid tumors]. / Aztreonam ed oxacillina nel trattamento dei pazienti febbrili neutropenici con tumori solidi.

22 consecutive febrile episodes in 21 neutropenic (PMN less than 1000/mmc) cancer patients, were treated with aztreonam and oxacillin. Nineteen patients were severely neutropenic (PMN less than 500/mmc). Cure was obtained in 86% of the febrile episodes, including 6/7 bacteriologically documented gram negative infections. No major side effects were observed. These results seem to indicate that aztreonam is effective as empiric treatment of gram negative infections in neutropenic patients. However, it must be used in combination with another antibiotic to ensure gram positive coverage.

[Fluorouracil and high-dose folinic acid in the treatment of advanced colorectal carcinoma]. / Fluorouracile ed acido folinico ad alte dosi nel trattamento del carcinoma del colon-retto in fase avanzata.

Forty-five consecutive patients with advanced colorectal cancer were treated with 5-fluorouracil and high dose folinic acid. Among 43 evaluable patients there were 7 objective responses for an overall response rate of 16%. Toxicity was generally mild and rapidly reversible. Compared to those reported with 5-fluorouracil alone, these results failed to demonstrate an increase in response rate in the treatment of advanced colorectal cancer with the combination of 5-fluorouracil and folinic acid.