A case of solitary and metachronous breast metastases from a renal cell carcinoma is described nine years after surgery. The review of the literature proves that the breast is an unusual site for metastatic disease.

The combination of epirubicin, cisplatin, and protracted venous-infusion 5-fluorouracil is the standard treatment of advanced gastric carcinoma in many European countries, and it is also an active regimen in hepatobiliary tumors. Raltitrexed is a specific inhibitor of thymidylate synthase with clinical activity in gastrointestinal malignancies. The aim of the study was to evaluate the clinical activity and toxicity of the combination of epirubicin, cisplatin, and raltitrexed in patients with advanced gastric and hepatobiliary tumors. Twenty consecutive patients with gastric carcinoma, 7 with biliary-tract carcinoma, and 5 patients with hepatocarcinoma were treated with epirubicin (60 mg/m2), cisplatin (60 mg/m2) on day 1, and raltitrexed (1 mg/m2) on days 1 and 8, every 3 weeks. The median age was 63 years (range, 28-76). Eight patients had locally advanced disease and 24 had metastatic tumors. Seven of the 18 evaluable patients (39%) with gastric carcinoma and 2 of the 5 patients with hepatocarcinoma have a partial response; 1 minimal response and 4 stabilization of disease were documented in the 7 patients with biliary-tract carcinoma. The median time to progression of the entire group was 6.8 months, and the median survival was 9.0 months. The toxicity was mild and no toxic death occurred. The combination of epirubicin, cisplatin, and raltitrexed, using this schedule, is tolerable and has clinical activity in gastric and hepatobiliary tumors.

Despite a sound preclinical rationale, this schedule of lonidamine and mitomycin C was ineffective and toxic in patients with advanced colorectal cancer. More experimental data about lonidamine are needed in order to design more effective regimens based on the combination of this interesting drug with other anticancer agents.

1 Labetalol 100 mg was given intravenously to 27 patients with essential hypertension (12 males, 15 females; WHO I‐II; age range 30‐66 yr; on average, a significant reduction of blood pressure was observed within 5 min (P less than 0.001). Average heart rate was also reduced significantly (P less than 0.01). 2 In 18 patients haemodynamic measurements were performed (dye‐dilution or thermodilution technique): blood pressure reduction was related to peripheral vasodilatation, as cardiac index remained unmodified. 3 The absolute and percentage decrease of blood pressure, heart rate and total peripheral resistance after labetalol 100 mg intravenously, was significantly greater in the patients with higher baseline plasma noradrenaline concentration values. 4 In 12 out of 27 patients labetalol was given orally for 2 months (dose range 300‐1200 mg); the pattern of blood pressure and heart rate changes after oral therapy were comparable to those observed after acute administration of the drug. 5 The degree of blood pressure and heart rate reductions after oral labetalol was also significantly related to pretreatment basal noradrenaline concentration.

No abstract