The efficacy and toxicity of the new anthracycline, 4'-0-tetrahydropyranyl doxorubicin (THP) (50 mg/m2 intravenous [IV] bolus) in association with cisplatin (100 mg/m2 IV as a 4-hour infusion) was assessed in 31 patients with advanced ovarian carcinoma. Twenty-eight patients were assessable for toxicity among whom 25 were assessable for response (International Federation of Gynecology and Obstetrics [FIGO] stage IIIa, four patients; IIIb, 15 patients; IV, six patients). Nine patients had received prior treatment. Patients were randomized to receive schedule (sch) A (THP at 6 hours, then cisplatin from 16 to 20 hours) or sch B (THP at 18 hours, then cisplatin from 4 to 8 hours). Sch A was hypothesized as less toxic since THP was best tolerated in the late rest span and cisplatin near the middle of the activity span in experimental studies. The rate of clinical complete response (CR) was 52%, that of partial response (PR) was 12%, and the overall clinical response rate (CR plus PR) was 64% (sch A, 73%; sch B, 57%). Median progression-free survival and survival times were, respectively, 10 and 19 months. Of 12 patients in clinical CR evaluated at second-look laparotomy, four had a pathological CR (33%), and three had microscopic residual disease (MD). The overall rate of pathological CR was 16%. Sch A was associated with less neutropenia (P = .10), thrombocytopenia (P less than .01), anemia (P less than .01), and renal toxicity (P less than .05) than sch B. Of four patients withdrawn for toxicity, three were on sch B (one death). Mean dose intensities (DIs) of THP and cisplatin, respectively, decreased by 30% and 47% over the five initial courses. Such decrease was significantly more pronounced for sch B than for sch A in previously untreated patients (P from 2-way analysis of variance [ANOVA] less than .01). THP-cisplatin is active against advanced ovarian cancer, and its toxicities can be significantly decreased by dosing THP in the early morning and cisplatin in the late afternoon as compared with THP in the evening and cisplatin the next morning.

EXCELLENT results with renal transplantation between identical twins by Murray, Merrill and Harrison (1958) This paper will not cover the basic problem of the homograft reaction but deal with data from six kidney transplantations performed at the Centre Midico-Chirurgical Foch at Suresnes. None were twins and four were done between nonrelated persons. In five cases total body irradiation was used to prevent rejection. It was given at the Gustave Roussy Institute at Villejuif (Seine) under the supervision of Drs. Tubiana and Lalanne. The treatment of such patients requires the help of a skilled medical and nursing staff. We are most grateful to all who helped us. Some results have already been published (Kuss, 1960 and 196I).A summary of all cases is presented in the following table. Selection of the DonorWe consider that at the present time this is the major problem. Most of the recent attempts involved the removal of a normal kidney from a healthy volunteer. In our series this was done four times. The risk, immediate and secondary, of a nephrectomy to the donor compared with the still small probability of a long-term success of the transplantation faces the physician in charge of the decision with very difficult moral, religious and legal problems.

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MEDIBCRAITIOA volunteers, and a British strain in doses ranging from 10' to 106 EID.0 to 30 volunteers. One month later 75 of the vaccinated volunteers were given 104 EID50 of the British vaccine. In addition, 55 volunteers with neutralizing antibody were given 107 EID50 of the Iksha vaccine by drops or spray, and 53 volunteers were given the same dose of vaccine inactivated with formalin.Of the volunteers without antibody 41% had mild respiratory symptoms after the first dose, and 8% after the challenging dose; 9 % of the volunteers with antibody who were given live vaccine had similar symptoms.Virus was recovered from 25% of the volunteers without antibody after the first dose of vaccine, and from 5 % after the challenging dose. Immediately before the challenging dose of vaccine 21% of the volunteers showed fourfold or greater haemagglutination-inhibition antibody response and 21 % a complement-fixation response; two weeks after the challenging dose the proportions were 29% and 19%, respectively.A much higher proportion of volunteers showed an antibody response after live than after inactivated vaccine.A dose of 10' EID50 of the British vaccine gave similar results to that of 106 or 107 EID50 of the Iksha vaccine.