The authors treated 41 cases of advanced solid tumors by a combination chemotherapy with methotrexate, vinblastine and cyclophosphamide administered in a sequential manner according to the hypothesis of a circadiam rhythm of proliferation of human neoplasia. A tumoral regression was observed in 66. 6 p. cent of adenocarcinomas and 86.2 p.cent of non glandular carcinomas.

Intensive care units for hematology or oncology patients consist of rooms free from pathogenic germs and low in microbe content. The units are staffed by doctors and nurses checked to be non carriers of pathogenic germs, and platelet and granulocyte transfusions are available. The first of these rooms, the Unit Fred-Siguier at the Hospital Paul-Brousse (Villejuif), was created for patients receiving bone marrow transplantation. Several units now exist in Europe. Results from two cooperative chemotherapy trials conducted at a European level showed that the number of remissions was double in services equipped with such rooms when compared with other hospital services. The study thus provides further evidence of the great need for such intensive care units.

D.T.I.C. appears more and more to possess the characteristics of an effective chemical agent in the treatment of naevocarcinoma. Having been able to include it in a mixed chemotherapy programme used in a group of 44 patients, we report here our findings. This is a preliminary study, the results of which will have to be confirmed in time on a larger group of patients over a longer period of observation.

16 patients suffering from primary bronchial tumours which had recurred after surgery and/or radiotherapy and with spread involving at least one visceral or lymphatic metastasis received chemotherapy consisting of the administration of vincristine followed by a combination of CCNU and 5-fluorouracil. Each cycle of treatment lasted 6 days and was restarted only after an interval of 30 days on average, this being necessary for haematological recovery. With the doses of CCNU used, thrombocytopaenia occurred only during the fifth cycle of treatment and made it necessary to increase the interval between subsequent courses to five weeks. All of the patients included in the study have now been followed up for between six and eighteen months. Two patients are presently in complete remission without apparent radiological, clinical or bronchoscopic signs. In seven other patients there was tumour regression greater than 50 p.cent persisting for four to six months. In seven, the therapeutic effect was transient or nil.

27 patients suffering from disseminated carcinoma of the breast with at least two visceral metastases, and two had become resistant to conventional chemotherpy and hormones, received a combination of, in the present trial, vincristine followed by cyclophosphamide with 5-fluoro-uracil. Chemotherapy was administered intermittently: each cycle of treatment lasted 6 days and was followed by a period without treatment of 25 days. Haematological tolerance was satisfactory. No serious incidents occurred during two years use of the combination. 20 out of 27 patients showed objective tumour regression of more than 50 p.cent lasting for more than 6 months, whilst 9 showed apparent complete regression of the malignant lesions. There was one complete failure. Chemotherapy was continued in all cases after regression of the neoplastic process was obtained.

17 patients suffering from primary tumours of the central nervous system recurring after surgery and/or radiotherapy, received chemotherapy consisting of the administration of VM 26 followed by CCNU. Each cycle of treatment lasted four days and was restarted only after an average interval of 30 days to allow for haematological recovery. All of the patients in the trial have been under treatment for eight months. Five (28 p.cent) are at present in complete remission with no residual clinical, isotopic or radiological signs. In six others there was tumour regression and in four neurological stabilisation. In all those cases where objective tumour regression was obtained functional improvement was noted.

The in vitro sensitivity of leukemic cells to cytotoxic drugs was assessed in 61 cases of acute leukemia in adults, 49 of them were of the no lymphoblastic type and in the first phase of the disease. The depression of the incorporation of 14-C-thymidine and 3-H-uridine after a two hours incubation with the various cytotoxic drugs was compared with the clinical result obtained with two of them There is a significant correlation between the in vitro depression of the incorporation of 14-C-thymidine and the clinical effect of the drugs. This method, which may be utilized also in solid tumors, allows to predict with some accuracy the effect of chemotherapy, and to select between the various cytotoxic drugs. However the failure of a chemotherapy is generally related to an in vitro insensitivity of the malignant cells to almost all drugs.