Bleomycin Chemotherapy

Bleomycin Chemotherapy focuses on the clinical uses of bleomycin. Bleomycin, a group of glycopeptides isolated from Streptomyces verticillus, has a unique structure and mechanism of action among anticancer drugs. The drug's remarkable lack of bone marrow toxicity prompted its addition to myelosuppressive regimens and enabled treatment of patients with compromised hematopoietic function. Bleomycin is an integral component of one of the great triumphs of medical oncology-the curative treatment of metastatic testicular carcinomas. Similar curative potential has been demonstrated for bleomycin in combination with cisplatin and vinblastine in germ-cell cancers of the ovary. Bleomycin is included in several important treatment regimens for Hodgkin's disease and non-Hodgkin's lymphomas. The drug also has clinical activity against squamous carcinomas of various sites. These uses and other aspects, including the development of new bleomycin analogs, are discussed in the following chapters, which were first presented at a symposium jointly sponsored by the Northern California Cancer Program and Bristol Laboratories in San Francisco, California, 14-15 September 1984.

ContributorsPrefaceI. Introduction 1. Bleomycin: More than a Decade Later I. Introduction II. Testicular Cancer III. Hodgkin's Disease IV. Non-Hodgkin's Lymphoma V. Head and Neck Cancers VI. Uterine Cervical Cancer VII. Conclusion References 2 Clinical Pharmacology of Bleomycin I. Pharmaceutical Properties II. Mechanism of Action III. Pharmacokinetics IV. Clinical Use ReferencesII. Testicular and Ovarian Cancers 3. Chemotherapy of Testicular Carcinoma: An Overview I. Introduction II. Chemotherapy III. Prognostic Variables IV. Toxicity V. Conclusion References 4. The Memorial Hospital Experience in the Management of Testicular Germ-Cell Tumors I. Introduction II. The VAB II Regimen III. The VAB III Regimen IV. VAB IV and VAB V Regimens V. The VAB VI Regimen VI. Adjuvant Surgery VII. Conclusion References 5. Effective Treatment of Malignant Ovarian Germ-Cell Tumors with Cisplatin, Vinblastine, and Bleomycin (PVB) I. Introduction II. Methods III. Results IV. Discussion ReferencesIII. Head and Neck Cancer 6. The Role of Chemotherapy in the Treatment of Head and Neck Cancer I. Introduction II. Salvage Treatment III. Primary Treatment IV. Prognostic Factors V. Conclusions References 7. Head and Neck Cancer: Bleomycin plus Radiotherapy I. Introduction II. Randomized Studies III. Nonrandomized Studies IV. Normal Tissue Effects of Combined Treatment V. Discussion References 8. The Role of Induction Chemotherapy in Combined-Modality Treatment Programs I. Introduction II. Effect on Treatment and Survival III. Testicular Cancer IV. Osteosarcoma V. Head and Neck Cancer VI. Discussion VII. Summary References 9. Induction Chemotherapy in the Treatment of Head and Neck Cancer: SUNY Buffalo and VAMC Experience I. Introduction II. Methods III. Results IV. Discussion V. Conclusion ReferencesIV. The Malignant Lymphomas 10. Hodgkin's Disease: an Overview and ABVD Studies in Milan I. Introduction II. MOPP versus ABVD III. Salvage Treatment IV. Cyclic MOPP/ABVD V. Conclusion References 11. Bleomycin in Combination with MOPP in the Management of Advanced Hodgkin's Disease: A Southwest Oncology Group Experience I. Introduction II. Patients and Methods III. Results IV. Discussion References 12. Combined-Modality Studies in the Treatment of Hodgkin's Disease I. Background II. Prospective Clinical Trials III. Combined-Modality Therapy in Pediatric Hodgkin's Disease IV. Future Directions References 13. The Non-Hodgkin's Lymphomas: an Overview I. Low-Grade Lymphomas II. Intermediate-Grade Lymphomas III. High-Grade Lymphomas IV. Future Directions References 14. Non-Hodgkin's Lymphomas: Milan Studies I. Introduction II. Combined-Modality Therapy for Stage I to Stage II Disease III. Alternating Chemotherapy in Stage III to Stage IV Disease IV. Conclusion Reference 15. BACOP and Related Studies in Non-Hodgkin's Lymphoma I. Single-Agent Bleomycin II. Bleomycin in Chemotherapy Combinations III. Four- and Five-Drug Regimens IV. Therapeutic Programs Using Continuous-Infusion Bleomycin V. New Intensive-Treatment Multidrug Regimens ReferencesV. Non-Small-Cell Lung Cancer 16.