chromomycin-a3 and Nausea

As adverse reactions to the combination treatment by the digestive system, we observed the occurrence of nausea and vomiting in 15% of the cases who received FTP treatment consisting of 5-FU, toyomicin and prednisone, 25% of the cases who received MFU treatment consisting of MMC, 5-FU and ACNU, and in 64% of the cases who received PPQ treatment consisting of CDDP, Carboquone (CQ) and prednisone. The antiemetics usually used are metoclopramide and droperidol, and we preadminister valproate preparation when persistent and delayed emesis is predicted. Several randomized trials have been made, and good efficacies with drugs such as metoclopramide, domperidone and steroid have been reported. Efficacy was good with acute emesis, but nonexistent with delayed emesis. As to the liver injury, in our combination treatment, only one case showed elevation of GPT by more than 500 units in the cases treated with MFU, while, increase in liver enzymes in the blood was observed in 10-20% of the cases. Similarly, there were not so many cases of liver injury during PPQ treatment. Thus, liver injury due to carcinostatic would be less frequent. Moreover, autopsy revealed hepatocellular-type of liver injury, cholestatic type liver injury and fatty metamorphosis at reasonable incidence. There were no typical cases of veno-occlusive disease which are noticed recently. The most important point for prevention and countermeasures against liver injury is to be careful not to use the previously mentioned drugs exhibiting toxicity in the liver if hepatic disease exists.

Topics: Antiemetics; Antineoplastic Combined Chemotherapy Protocols; Carbazilquinone; Chemical and Drug Induced Liver Injury; Chromomycin A3; Fluorouracil; Humans; Liver; Mitomycin; Mitomycins; Nausea; Nimustine; Organoplatinum Compounds; Prednisone; Vomiting

Chromomycin A3 was administered iv to 26 patients in a phase I trial. The maximum tolerated dose established in this study was 0.75 mg/m2/day iv X 5 days. The drug was then given to 48 evaluable patients with far-advanced disseminated breast cancer. Two short partial remissions and one clinical improvement were seen. Toxic manifestations consisted of frequent and usually reversible renal toxicity, nausea and vomiting, occasional thrombocytopenia, hypocalcemia, and two instances of semicoma. Drug toxicity may have contributed to the death of two patients.

Topics: Breast Neoplasms; Chromomycin A3; Chromomycins; Drug Evaluation; Female; Humans; Hypocalcemia; Kidney; Nausea; Neoplasm Metastasis; Remission, Spontaneous; Vomiting