Biological effects of the phosphoramides in patients with advanced cancer

HEMICAL anticancer agents are now avail-c able that offer some measure ol palliation for patients with advanced carcinoma.In contrast to cancers of the hematopoietic system, for which chemical therapy has been available for approximately ten years, drugs have only recently been developed for the palliation of epithelial cancers.Because certain ethyleneimines have been shown to have a carcinolytic action against a few carcinomas,ll 8 , 53 6 , 9 a clinical study of the effects of triethylenephosphoramide (TEPA) and triethylenethiophosphoramide (TSPA) has been undertaken at the University of Minnesota Hospitals, the Veterans Administration Hospital, and the Minneapolis General Hospital.Thirty-four patients with various cancers have been treated during 1955 and 1956.Studies have been made that relate tumor response to leukopenia and cffects of thc drugs on the purine metabolism of the body.411 patients had Par-advanced cancer, considered to be beyond control with the usual methods of therapy.T h e patients were hospitalized for constant observation and laboratory study during the course of TEPA and TSPA therapy. METHODST h e intramuscular route of administration was used for all patients.For the first five days, a 10-mg.dose was given daily, and then subsequent smaller daily doses were administered, for a total o€ 70 to 150 rng.Early experience indicated that maximum white-blood-cell depression was delayed for approximately ten days after the initiation of the first course 01From the departments of Surgeiy of the tJniversity of Minnesota, the Veterans Administration Hospital, and the Minneapolis General Hmpital, Minneapolis, Minnesota.T h e authors wish to thank Dr. William Weyraudi for his clinical assistance.IVe are indebted to Dr.