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A Clinical Evaluation of a Prolonged Schedule of Cytosine Arabinoside (NSC 63878)¹

Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, and The Oncology Service, Baltimore City Hospitals, Baltimore, Maryland 21224 [P. J. B., A. H. O.]; Department of Medicine, Jackson Memorial Hospital, University of Miami School of Medicine, Miami, Florida 33136 [J. C.]; Georgetown University, Medical Division, District of Columbia General Hospital, Washington, D. C. 20003, and Department of Medicine, Georgetown University School of Medicine, Washington, D. C. 20007 [B. I. S.]; Department of Medicine, Maimonides Hospital of Brooklyn, Brooklyn, New York 11219 [J. H. E.]; Boston University Medical Center, University Hospital, Boston, Massachusetts 02118 [A. S.]; Jefferson Medical College Division, Philadelphia General Hospital, Philadelphia, Pennsylvania 19104 [H. S. B.]; Departments of Medicine and Clinical Pharmacology, University of Vermont School of Medicine, Burlington, Vermont 05401 [H. J. W.]; and the University of Rochester, School of Medicine and Dentistry, Rochester, New York 14620 [T. C. H.]

The effect of repeated 10-day courses of s.c. administered arabinosyl cytosine was evaluated in 85 patients with metastatic cancer. This study attempted to exploit the presumed kinetic characteristics of slow-growing tumors and the pharmacological properties of a cell cycledependent drug. A dose of 0.4 mg/kg given every 8 hr for 30 doses consistently produced tolerable hematological toxicity without other untoward effects. Myelosuppression was less with the 2nd course. A biphasic white blood cell depression was noted.

Tumor regression was transient and occurred in less than 10% of the cases.

¹ This study was undertaken by the Eastern Cooperative Oncology Group (Chairman, Dr. Bruce I. Shnider). Investigations were supported by the USPHS Research Grants CA 06973 [P. J. B., A. H. O.], CA 02822 [J. C.], CA 02824 [B. I. S.], CA 05588 [J. H. E.], CA 11109 [A. S.], and CA 11083 [T. C. H.], from the National Cancer Institute, NIH. The drug was furnished by Cancer Therapy Evaluation Branch, National Cancer Institute, Bethesda, Md. Address reprint requests to: Dr. Philip J. Burke, Room 304, Carnegie Building, The Johns Hopkins Hospital, 601 North Broadway, Baltimore, Md. 21205.

Received 11/25/69. Accepted 1/22/70.