Reports suggesting that delta 9-tetrahydrocannabinol (THC) had a potent antiemetic effect in patients treated with cancer chemotherapeutic agents led to the synthesis of other cannabinol derivatives with possibly less side effects. We report here our initial observations with the antiemetic levonantradol in 12 patients with advanced solid tumors receiving cytotoxic polychemotherapy. All patients had a history of vomiting and nausea without successful treatment with standard antiemetic drugs in previous, identical chemotherapy cycles. No other antiemetic or psychoactive drugs were given. Patients received 1 mg levonantradol i.m. 2 hours before as well as 2 and 6 hours after cytotoxic treatment. When compared to the last course of chemotherapy with alternate antiemetic drugs, we found that 11/12 patients had less nausea and vomiting when treated with levonantradol. 8/12 Patients considered the antiemetic treatment with levonantradol better than the one given before. The following side effects were observed: 4 patients complained of pain and local irritation after injection. 2 patients showed a fall in blood pressure, especially orthostatic hypotension. 8 patients complained of sedation and drowsiness. 7 patients experienced psychic side effects, such as decrease of vigilance and reaction, altered sense of timing, body image distortions and even depersonalization. Levonantradol is a potent antiemetic drug but its applicability, especially in outpatients, may be complicated by a high incidence of side effects.

Antiemetics↗

PubMedDate not supplied

Randomized trial in advanced breast cancer using combination chemotherapy with or without C. parvum; preliminary results.

In a prospectively randomized cooperative study patients with metastatic breast cancer were treated with or without Corynebacterium parvum (C.p.)5 mg/sc/m2 on day 1 in addition to CAO/CMF (Cyclophosphamid (C) 150 mg/m2/d per os X 5 d and Adriamycine (A) 50 mg/m2 i.v. d 1 and Oncovin (O) 1.0 mg/m2 i.v. d 1. 6 CAO-cycles q 28 days later were followed by monthly CMF cycles q 28 d with Cyclophosphamide (same dose), Methotrexate 30 mg/m2 i.v. 1 and 5-fluorouracil 600 mg/m2 i.v. d 1). 76 patients entered the study until January 1, 1977. The patients' characteristics (age, cytostatic pretreatment, tumor free interval, metastatic sites and mean doses of CA) were well balanced in the two groups. The lowest values of WBC and platelets on d 14 of the monthly CAO-cycles show a mean nadir of 1,630/mm2 and 122'850/mm3 respectively in the C.p.-group and of 1,890/mm2 and 141'760/mm3 in the group without C.p. GI-toxicity was seen more frequently in the C.p. group. An improvement of symptoms was observed in 88% of the C.p.-CAO/CMF treated group and in 77% of the group without C.p. Complete and good partial remissions (greater than 50% tumor size reduction) were seen in 53% of the CAO-C.p. treated patients and in 34% of the patients in the control group without C.p. Survival data presently show a trend of improvement by the addition of C.p. to the CAO-CMF-chemotherapy regimen.

Breast Neoplasms↗