Cis-Dichlorodiammine platinum and adriamycin therapy for advanced gynecological and genitourinary neoplasms.

Abstract

Cis-Dichlorodiammine platinum (DDP) 75 mg/m2 on days 1 and 8 and Adriamycin (ADR) 60 mg/m2 on day 1 were used in 31 patients with advanced gynecological and genitourinary neoplasms. The DDP was given by 6 hours intravenous infusion with 2 liters of 5% Dextrose and 0.5 normal saline using Mannitol and/or furosemide diuresis. Courses were repeated every 21 to 28 days. Responses were seen in 7 of 8 patients with germinal cell neoplasms (5 complete, 2 partial) with a median duration of eight months. A partial response was obtained in 3 of 7 patients with bladder carcinoma with a median duration of three months. There were four partial responses obtained in 9 patients with ovarian carcinoma with a median duration of five months. Toxicities included nausea and vomiting in all 31 patients, nephrotoxicity (serum creatinine > 2 g/100 ml) in patients, tinnitus and/or high frequency hearing loss in 10 patients, and neurotoxicity (peripheral neuropathy, normal pressure hydrocephalus, papilledema) in 8 patients. Severe leukopenia (WBC < 2000/cu mm) and thrombocytopenia (< 100,000/cu mm) occurred in 25% and 45% of evaluable courses, respectively and necessitated dosage reduction in all and delay of therapy in some patients. Peak plasma Pt levels were 2.61 +/- .18 microgram/cc on day 1 and 3.52 +/- .39 microgram/cc on day 8 with a longer terminal half-life on day 8 (252 hours) compared to day 1 (156 hours). Peak plasma ADR levels ranged from .53 to 1.67 N moles/cc with an average terminal half-life of 22.8 hours. This agrees with values of ADR when given alone. This dose and schedule of DDP-ADR is active against advanced gynecological and genitourinary neoplasms, but the amount of toxicity seen indicates that modifications will have to be made.

• Authors: S Ostrow, M J Egorin, D Hahn, S Markus, A Leroy, P Chang, M Klein, N R Bachur, P H Wiernik
• Journal: Cancer (Cancer) Vol. 46 Issue 8 Pg. 1715-21 (Oct 15 1980) ISSN: 0008-543X [Print] United States
• PMID: 7191768 (Publication Type: Journal Article)

Chemical References

• Furosemide
• Doxorubicin
• Cisplatin

Topics

• Adolescent
• Adult
• Aged
• Blood Platelet Disorders (chemically induced)
• Cisplatin (administration & dosage, adverse effects, metabolism)
• Doxorubicin (administration & dosage, adverse effects, metabolism)
• Drug Administration Schedule
• Drug Therapy, Combination
• Female
• Furosemide (therapeutic use)
• Genital Neoplasms, Female (drug therapy)
• Hearing Loss (chemically induced)
• Humans
• Kidney Diseases (chemically induced)
• Kinetics
• Leukopenia (chemically induced)
• Male
• Middle Aged
• Neoplasm Metastasis
• Nervous System Diseases (chemically induced)
• Tinnitus (chemically induced)
• Urogenital Neoplasms (drug therapy)