A FEASIBILITY STUDY OF TESTING NEW DRUGS FOR SMALL-CELL LUNG-CANCER IN PATIENTS WITH A POOR PERFORMANCE STATUS

Testing of new drugs in small-cell lung cancer is definitely necessary for the development of agents that might be effective against this tumor. However, testing such drugs in previously untreated patients with a good performance status (PS) may give rise to ethical problems. When previously treated patients are used in testing, potentially effective agents could well elude discovery. Patients who are not eligible for "standard" combination chemotherapy, e.g. untreated patients with a poor PS, may be suitable for testing of new drugs. To evaluate the potential usefulness of such patients in the testing of new agents, we evaluated an effective drug (etoposide) at a relatively non-toxic dose in a group of 14 patients with a PS of 4 (WHO). Oral etoposide resulted in a response in only 3 cases, whereas 5 subjects died of therapy-related toxicity. We conclude that previously untreated patients with a poor PS are not suitable candidates for the testing of new drugs

ABSENCE OF AN ADDITIONAL FIBROTIC RESPONSE CAUSED BY OXYGEN IN THE LUNGS OF RATS AFTER THE INTRATRACHEAL ADMINISTRATION OF BLEOMYCIN

The hypothesis proposed by Goldiner and col-leagues [1] that the pulmonary complications observed in some bleomcyin-treated patients may be the result of an interaction with hyperoxia during or after subsequent surgery, is still a matter of debate. In recent years, evidence for synergistic pulmonary toxicity has been collected from experiments in several animal species in which bleomycin had been instilled to the trachea before exposure to high concentrations of oxygen [2-6]. In all except one [4] of these studies, the dose of bleomycin was 5 mg kg'1 or more—a dose comparable to that administered in man. How-ever, in contrast to clinical practice where bleo-mycin is delivered i.v., in animals it is directly supplied to the lungs. This route of administration is expected to create pulmonary concentrations of belomycin several times greater than those obtained after i.v. injection, after which bleomycin must pass the lung endothelium, a tissue con-taining the bleomycin metabolizing enzyme bleomycin several times greater than those however, that quantitative differences between species have been reported [7] in regard to the activity of this enzyme. Moreover, in virtually all investigations in animals the oxygen concentratio