Stephen K. Carter – författare

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.

The impressive advances in all branches of medical science during the first half of this century with the discovery of many chemotherapeutic or immunogenic agents gave rise to brilliant achievements in the struggle against some infectious diseases and aroused in many scientists the wishful thought that drugs for cancer therapy would, soon lead to additional great success. Notwithstanding ever-increasing worldwide endeavors, the major problems in prevention or treatment of neoplastic diseases are still unsolved. The approach to the resolution of these problems follows many different pathways. Basic research tries to cast light on the genetic and biochemical processes underly­ ing cell division and differentiation as well as the interactions occurring between the cell and the oncogenic stimulus, or between the neoplastic cells and the different body systems endowed with immunological reactivity. Another line of approach, coherent with the classic basis of chemotherapy, relies upon the search for new compounds selectively blocking the multiplication of the neoplastic cells. The remarkable progress made in treating human cancer, as a result of these efforts, has been until now ascribable chiefly to the accomplishment of the chemo­ therapeutic approach. Studies on the cytostatic activity of the anthracycline antibiotics carried out over many years eventually led the investigators of Farmitalia (Milan, Italy) to discover and characterize some new compounds endowed with interesting chemotherapeutic properties against malignant neoplastic diseases.

The impressive advances in all branches of medical science during the first half of this century with the discovery of many chemotherapeutic or immunogenic agents gave rise to brilliant achievements in the struggle against some infectious diseases and aroused in many scientists the wishful thought that drugs for cancer therapy would, soon lead to additional great success. Notwithstanding ever-increasing worldwide endeavors, the major problems in prevention or treatment of neoplastic diseases are still unsolved. The approach to the resolution of these problems follows many different pathways. Basic research tries to cast light on the genetic and biochemical processes underly­ ing cell division and differentiation as well as the interactions occurring between the cell and the oncogenic stimulus, or between the neoplastic cells and the different body systems endowed with immunological reactivity. Another line of approach, coherent with the classic basis of chemotherapy, relies upon the search for new compounds selectively blocking the multiplication of the neoplastic cells. The remarkable progress made in treating human cancer, as a result of these efforts, has been until now ascribable chiefly to the accomplishment of the chemo­ therapeutic approach. Studies on the cytostatic activity of the anthracycline antibiotics carried out over many years eventually led the investigators of Farmitalia (Milan, Italy) to discover and characterize some new compounds endowed with interesting chemotherapeutic properties against malignant neoplastic diseases.

F. M. MUGGIA When faced with the inadequacies of current cancer treatment, we prefer to look at what the future may hold. Quite often, we take for granted the past, preferring research into totally new areas. However, the persistent development of fertile soil may yield surprising rewards for those who choose to build on the knowledge of the past--hence, this symposium on anthracycline antibiotics. Although the anthracycline antibiotics represent much of the present and future of cancer treatment, their actual use c stretches back barely two decades to the pioneering efforts of Aurelio Di Marco, who characterized the antitumor properties of daunomycin and adriamycin. * The clinical application of these two compounds heralded a decade of excitement among oncologists dealing with pediatric tumors, breast cancer, leukemias, and lymphomas, and opened new hope for patients afflicted with sar­ comas and a variety of other tumors that had been deemed - sistant to chemotherapy. These successes were tempered with the realization that the antitumor effect of anthracyclines could be achieved at times only at the very high price of risking cardiac decompensation and, almost invariably, with the occurrence of alopecia and other acute toxicities. This record of past achievements and problems has slowly given way to a present increasingly illuminated by our ability to modify the distressing toxicities of these agents. Detailed clinical studies supplemented by ingenious laboratory models have gradually elucidated mechanisms and risk factors im­ plicated in the cardiomyopathy.