Platinum drugs in the treatment of non-small-cell lung cancer

The use of chemotherapy is considered standard therapy in patients with locally advanced non-small-cell lung cancer that cannot be treated with radiotherapy and in those with metastatic non-small-cell lung cancer and good performance status. This approach is also accepted in patients with earlier stage disease, when combined with radiotherapy in those with non-resectable locally advanced disease, or in the preoperative setting. Randomised clinical studies and meta-analyses of the literature have confirmed the beneficial survival effect of platinum-based chemotherapy. Cisplatin and carboplatin have been successfully used with other drugs in a wide variety of well-established two-drug combinations while three-drug combinations are still under investigation. Cisplatin and carboplatin use is limited by toxicity and inherent resistance. These considerations have prompted research into new platinum agents, such as the trinuclear platinum agent BBR3464, the platinum complex ZD0473 and oxaliplatin. These compounds could be developed in combination with agents such as paclitaxel, gemcitabine or vinorelbine in patients with advanced and/or refractory solid tumours

Influences of precipitation changes and direct CO2 effects on streamflow

Increasing atmospheric carbon dioxide concentrations are expected to cause major changes in the world's climate over the next 50-100 yr. The impact of such changes on water resources, through changing precipitation and evaporation, will, however, be complicated by the direct effects of increasing CO2 on vegetation. In controlled environment experiments, higher CO2 levels cause the stomata of plants to close down, decreasing their rate of transpiration and increasing their water use efficiency. Reduced evapotranspiration would make more water available as runoff and could tend to offset the effects of any CO2-induced reductions in precipitation or enhance the effects of precipitation increases. We consider here, in a simple but revealing analysis, the relative sensitivity of runoff to these two processes, changes in precipitation and changes in evapotranspiration. We show that, for low runoff ratios, small changes in precipitation may cause large changes in runoff. The magnitude and direction of these changes is, however, strongly dependent on the magnitude of the direct CO2 effect on plant evapotranspiration