Single Agent Versus Combination Chemotherapy

Dr.DeVita: Not entirely. Certain types of tumors have demonstrated remark able responsiveness to single agents. The success of methotrexate in the treatment of choriocarcinoma is well known. Over 70 percent of women can be cured, even if the disease is widely disseminated. Choriocarcinoma's exquisite responsiveness to single agent ther apy may be related, in part, to its rapid proliferation and the host's ability to mount an effective immune response to what may be allo geneic residual disease. To no small extent, therapy has been aided by the presence of a marker. chorionic gonadotrophin. Another tumor that is responsive enough to single agent chemo therapy to warrant the word “¿ cure― is Burkitt's lymphoma@ 20 per cent of Burkitt's original patients achieved long-term remission using minimal amounts of cyclophosphamide alone. In a random ized trial of single or multiple high doses of cyclophosphamide conducted by the National Cancer Institute's unit in Uganda, 10 of 11 patients with localized disease (Stages I or II) have sustained long remissions. Multiple doses of cyclophosphamide were no more effective than single doses in patients with localized disease, but it must be emphasized that multiple doses of this potent immuno suppressive agent failed to do any harm. Relapses were no more