Admixtures of Chemotherapy Agents by Continuous Infusion

  • Jacob J. Lokich
Part of the Medical Radiology book series (MEDRAD)

Abstract

The application of multiple drugs or combination chemotherapy for the treatment of cancer has become standard practice since its introduction in the 1960s for the treatment of first testicular cancer and subsequently leukemias and Hodgkin’s disease. Today chemotherapy for malignancies virtually always entails the application of multiple agents, either simultaneously or in some planned sequence. The rationale for combination chemotherapy is based upon the concept of affecting multiple metabolic sites within the tumor cell or multiple points during the tumor cell cycle. At a practical level, the use of non-cross-resistant agents without overlapping toxicity maximizes the effectiveness of such combinations. Recent conceptual advances in the application of cancer chemotherapy have introduced the concept of alternating non-cross-resistant agents applied intensively on a weekly basis. Another conceptual development has been the application of biochemical modulation utilizing a noncytotoxic enhancing agent in conjunction with a primary cytotoxic drug.

Keywords

Toxicity Cyclophosphamide Alkaloid Myeloma Dura 

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References

  1. Anderson N, Lokich J, Bern M et al. (1989a) Combined 5-fluorouracil administered as a 14-day infusion. Cancer 63: 825–827PubMedCrossRefGoogle Scholar
  2. Anderson N, Wallach S, Lokich J et al. (1989b) VP16–213 + cisplatinum: 72 hour continuous admixed infusion in 94 patients. ASCO Abs.Google Scholar
  3. Anderson N, Lokich J, Bern M et al. (1989c) A Phase I clinical trial of combined fluoropyrimidines with leuco- vorin in a 14-day infusion. Cancer 6: 233–237CrossRefGoogle Scholar
  4. Bargolie B, Smith L, Alexamann R (1984) Effective treatment of advanced multiple myeloma refractory to alkylating agents. N Engl J Med 310: 1353–1356CrossRefGoogle Scholar
  5. Creagan E, Richardson R, Kovach J (1988) Pilot study of a continuous five-day intravenous infusion of etoposide concomitant with cisplatin in selected patients with advanced cancer. J Clin Oncol 6: 1197–1201PubMedGoogle Scholar
  6. Kish J, Eusley J, Weaver A et al. (1984) Superior response rate with 96 hours 5FU infusion vs 5FU bolus. PASCO Abs. C-695Google Scholar
  7. Legha SS, Benjamin RS, MacKay B et al. (1982) Role of Adriamycin in breast cancer and sarcomas. In: Muggia FM, Young CW, Carter SK (eds) Anthracycline antibiotics in cancer therapy. Nijhoff, The Hague, pp 432–434Google Scholar
  8. Lokich J (1986) Protracted infusional chemotherapy. In: Lokich J (ed) Cancer chemotherapy by infusion. Precept, Chicago, pp 243–264Google Scholar
  9. Lokich J, Phillips D, Green R et al. (1985) 5-Fluorouracil and methotrexate administered simultaneously as a continuous infusion. Cancer 56: 2395–2398PubMedCrossRefGoogle Scholar
  10. Lokich J, Zipoli T, Moore C et al. (1986) Doxorubicin/ vinblastine and doxorubicin/cyclophosphamide combination chemotherapy by continuous infusion. Cancer 58: 1020–1023PubMedCrossRefGoogle Scholar
  11. Lokich J, Anderson N, Bern M et al. (1988) Combined floxuridine and cisplatin in a fourteen day infusion. Cancer 62: 2309–2312PubMedCrossRefGoogle Scholar
  12. Lokich J et al. (1989a) Cyclophesphamide, methotrexate, and 5-fluorouracil in a three-drug admixture. Cancer 1989: 63: 822–824CrossRefGoogle Scholar
  13. Lokich J, Ahlgren J, Gullo J et al. (1989b) A prospective randomized comparison of continuous infusion fluorouracil with a conventional bolus schedule in metastatic colorectal carcinoma: a Mid-Atlantic Oncology Program Study. J Clin Oncol 7: 425–432PubMedGoogle Scholar
  14. Lokich J, Anderson N, Bern M et al. (1989c) Etoposide admixed with cisplatin. Cancer 63: 818–821PubMedCrossRefGoogle Scholar
  15. Rosenthal J, Adriamycin and bleomycin combination admixture administered by continuous IV infusion alone and concomitantly with radiation therapy. (Protocol activated at Downstate 1988).Google Scholar
  16. Seargeant L, Kobrinsky N, Sus C et al. (1987) In vitro stability and compatability of daunorubicin, cytarabine and etoposide. Cancer Treat Rep 71: 1189–1192PubMedGoogle Scholar
  17. Seifert P, Baker LH, Reed ML et al. (1975) Comparison of continuously infused 5-fluorouracil with bolus injection in treatment of patients with colorectal cancer. Cancer 36: 123–128PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • Jacob J. Lokich
    • 1
  1. 1.New England Baptist HospitalBoston Cancer CenterBostonUSA

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