Abstracts/Lung Cancer 10 (1994) 395-430 429

of a photosensitising drug. There is some selectivity of uptake of photosensitisers in malignant tissue, although this is difficult to exploit. Full thickness necrosis in norms1 snd neoplsstic colon heals without perforation because of a lack of effect on collagen, making local cure a possibility. The experiments described here aim to establish whether these conclusions are also valid for bronchial turnouts. Mer/t&r - In pharmacokinetic studies normal rats were given 5 mg/kg of the photosensitiser aluminium sulphonated phthalocyanine (AISPc) intravenously and killed up to one month later. The distribution of AlSPcind~etracheawasmeasuredbychemicalextractioaandfluo-ce microscopy. In subsequent experiments sensitised animals were treated with light delivered to the tracheal mucosa through a thin flexible tibre and the resultant lesions werestudied fortheirsi=, mechanical strength, and healing. A series of resected human bronchial carcinomas were examined histologically for their collagen content. Resulrs - The tracheal ConcentrationofAlSPc innormal tats wasmaximum l-20 hours after administration. Fluorescence micmscopy revealed that most was in the perichondrium and submucosal stmma, with little in the cartilage. Light exposure showed necrosis of the soft tissues which healed by regeneration, but no effect on cartilage and no reduction in the mecbanicalstrengthofthetracheaatanystage. Histologicalexamination of resected human bronchial carcinomas showed more collagen in the tumour areas than would be found in normal regions. Conclusions - PDT leads to nocmsis of the soft tissues of the normal trachea but there is complete healing by regeneration, no risk ofperforation (due to collagen preservation). and no effect on cartilage. Human bronchial carcinomas apparently contain more collagen than normal bronchi which may give protection against perforation following necrosis induced by PDT. PDT may have a role in eradicating small volumes of tumour tissue in situ and could be valuable for treating (1) small carcinomas in patients unfit for resection, (2) tumour remaining after surgical resection. (3) stump recurrences, or (4) to prolong palliation of Nmours after debulking with the NdYAG laser.

A pilot study about effcacy of immunostimulating therapy in patients radically operated for non small cell lung cancer (stage 0. Early results Tos M. Cristaldi M. Cappelli R. Bellaviti N, Di Luiso P. Santambmgio L et al. c/o Ist. Chirurgia Generale/Toracica, Universira degli Stadi, Via F. Sforza 35, 20122 Milano. Chirurgia (Turin) 1992;5:589-91.

The authors present their experience about ‘timostimolina’ (TP-I Semno) therapy in patients radically resected between 1986-1988. for stage I non small cell lung cancer, particularly regarding the incidence of post-surgical infections and the ‘disease free’ period. Subjects were divided into two same groups of 20 patients each, as follow: a. TP-I group, undergoing post-operatively to ‘timostimolina’ administration at thadose of 1 mglkg by day alternatively, for 6Odays: b. ‘none’ group, not treated. There was no infection in the ‘thymostimulin group’ and 17 patients are alive after 24 months of follow-up, while 2 of them present local recurrence. In the ‘none group’ 2 pulmonary infections occurred after surgery, 14 patients are alive, 2 of whom with recurrence, 1 regional and I metastatic. We confirm the thymostimulin efficacy in preventing postoperative infections. It also seems to be some positive intluence on survival. These data have to be confirmed by an increased number of patients and by a longer follow-up.

lmmunotoxin therapy of small-cell lung cancer: N901-blocked rick for relapsed smalLceil lung cnncer Lynch TJ Jr. Division of Clinical Oncology, Dana-Farber Cancer Insrituw. HarvardMedicalSchool, Bosron, MA. Chest 1993: 103:Suppl. 436S-9s.

Despite its initial chemosensitivity, smaIl-cell lung cancer (SCLC)

is rarely cured with chemotherapy alone, and fewer than 5% of patients are alive at 5 years. Immtmotoxin therapy appears to offer promise in treating the minimal residual disease that remains after induction chemotherapy. We have studied N901-CR in patients with relapsed SCLS. N901-bRconsistsoftheN901 monoclonalantibody (MoAb)and blocked ricin, an altered ricin molecule in which the galactose bindiig

are blocked through die covalent bindiig of ligands. N901 is an anti- NCAM (CD56) MoAb which binds to SCLC Nmors and cell lines, cardiac muscle, natural killer (NK) cells; and peripheral nerve. N901- bR showed a 2.7 log greater in vitro cytotoxicity to the CDSC-positive cell line SE-2 than to the antigen-negative Namalwa cell line. Nineteen patients with relapsed antigen-negative Namalwa cell line. Nineteen patients with relapsed and/or refractory SCLC have been entered into a phase I study at doses tanging from 5 to 40 g/kg/day given as a 7-day continuousinfusion.Thedose-iimitingtoxicityiscapillaryleaksyndmme observed in two thirds of the patients treated at 40 g/kg/day. One patient at the maximum tolerated dose, 30 g/kg/day x7 days, has achieved a partial response to N901-bR. No patient has developed clinically significant peripheral or central neuropathy. We plan to begin a phase II sNdy of N901-bR following induction chemotherapy in patients with SCLC.

Role of phototherapy, laser therapy, btachytherapy, and prosthetic stents in the management of lung cnttcer Cortese DA. Edell ES. Mayo ClinicJacksonville, JSoOSaa Pablo Road, Jacksonville, FL 32224. Clin Chest Med 1993;14: 149-59.

This article describes the rationale. methods, results. and role in clinical practice of the bmnchoscopic therapeutic application of photodynamic therapy, laser therapy, brachytberapy, and prosthetic stems.

Reviews

Management of small-cell lung cancer Johnson BE. NCI-Naw Medical Oncology Branch, Nmional Naval Medical Cearer, Build& 8, Bethesda. MD 20889-5105. Clin Chest Med 1993; 14: 173-87.

The management of small-cell lung cancer initially require an accurate histologic diagnosis and determination of the anatomic extent of cancer dissemination. Patients should be treated wide 4 to 6 months of combination chemotherapy, and patients with limited stage also should be treated with chest irradiation. Chemotherapy treatment prolongs patient survival. and approximately 10% of patients with limited stage disease. can be cured of their cancer following treatment with combination chemotherapy and chest radiotherapy.

Epidemiology and etiology of lung cancer Beckett W.S. Yale Universify School of Medicine, CB 5029,333 Cedar Street, New Haven, CTO6510. Clin Chest Med 1993:14:1-16

Lung cancer incidence and mortality have increased sharply during this century, making it a common cause of de& and the most frequent

causes -cigarette smoking, asbestosand other occupational carcinogens, radon, and envimnmental tobacco smoke are responsible for the majority of cases. Although the proportion of adults who smoke in the United States has dropped since the mid-1960s. the incidence of lung cancer in the United States is expected to continue to rise through the 1990s because of the long latency between initiation of smoking and the occurrence of the disease. Efforts to alter lung cancer mortality by early