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MCCNU and cyclophosphamide are synergistic in animal tumor systems and have different chronology patterns for dose-limiting myelosuppression. The combination was employed in 49 patients with metastatic cancer with each drug administered on successive days and repeated at 6-week intervals. A total of 108 courses of therapy were monitored, and leukopenia (WBC less than 3,000 cells/mm3) and thrombocytopenia (platelets less than 150,000/mm3) were observed in 47 and 30%, respectively, at nadir days 15 and 22. No clinically beneficial effects were observed in 40 patients with measurable disease. Combination chemotherapy employing nitrosoureas have not, as in this study, generally demonstrated synergistic therapeutic effects possibly related to the low level of antitumor activity of nitrosoureas in solid tumors and the use of suboptimal doses for one of more agents in the combination.

6 patients with cutaneous malignant melanoma and multiple secondary cutaneous lesions were treated with intralesional methanol extraction residue of bacillus Calmette Guerin (MER-BCG). Separate lesion

47 patients with Hodgkin’s disease presenting after age 60 were analyzed retrospectively for clinical presentation, distribution of disease, and histopathology, and compared to a younger control group. The types of clinical presentation included: local or generalized adenopathy, 50%; ‘B’ symptoms, 25%; ‘unusual manifestations’ and intra-abdominal complications, 13%; and incidentally discovered disease, 12%. In contrast, the younger group presented less often for symptoms (p

2 patients with metastatic cancer (Ewing's sarcoma and breast cancer) developed pleural effusions while undergoing systemic therapy for pulmonary metastases. Thoracenteses failed to reveal malignant cells and in both instances the characteristics of the fluids were those of transudates. The effusions developed in association with dissolution of pulmonary lesions and presumably represent a reactive process to tumor regression.

19 patients with metastatic gastrointestinal malignancy were treated with a regimen of 5-fluorouracil (FU) 500 mg/m2 intravenously and hydroxyurea (HU) 80 MG/KG orally administered on consecutive days weekly. Antitumor responses were not observed and an unusually high incidence of neurotoxicity (21%) was noted related to dose. It is suggested that the lack of therapeutic effect and the observed toxicity may be related to the biochemical interaction of FU and HU resulting in an inability to convert FU to the active metabolite and an accumulation of catabolic products with neurotoxic effects.