A number of chemotherapeutic agents and multiple other drugs are known to produce interstitial pneumonitis and pulmonary fibrosis. It is important to realize which agents can produce or interact with other drugs to produce this complication. Two patients receiving combination chemotherapy with mitomycin‐C and vinblastine developed diffuse interstitial pulmonary infiltrates in temporal relationship to vinblastine administration. The infiltrates cleared but recurred and produced chronic pulmonary changes. Since it is likely that the vinblastine either caused or contributed to the pulmonary damage, this drug must be considered among the antineoplastic agents which can cause or contribute to interstitial pulmonary disease.

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As a result of successful therapy with radiation, chemotherapy, or both, patients with lymphoma are living longer. The improved survival has led to an increased awareness of long term complications including second or subsequent malignancies. We have recently seen six cases of lung cancer--three adenocarcinomas, one squamous cell carcinoma, and two small cell carcinomas--among 655 patients with Hodgkin and non-Hodgkin lymphoma suggesting a possible association, although other carcinogenic or cocarcinogenic factors cannot be eliminated.

Mitomycin C, 20 mg/m2 day 1, and vinblastine, 0.15 mg/m2 days 1 and 21, were administered intravenously to 31 patients with refractory previously treated advanced breast cancer. Courses were repeated every six to eight weeks when adequate hematologic recovery permitted. Thirty of the 31 patients were evaluable; one had a complete response and 11 had a partial response. Four patients had stabilization of their disease. There was a 12/30 (40%) response rate with a median response duration of 127 days (range 69--412 days). Toxicity included moderate to severe myelosuppression, infections, hemorrhage, neurologic symptoms, pulmonary toxicity and mucositis. In previously treated patients with poor prognoses, the combination of mitomycin C and vinblastine appears to be a worthwhile secondary treatment for metastatic breast cancer.