Clinical-benefit response in advanced non-small-cell lung cancer: A multicentre prospective randomised phase III study of single agent gemcitabine versus cisplatin-vindesine.

Background: The modest improvement in median survival of advanced non-small-cell lung cancer (NSCLC) by cisplatin-based chemotherapy has led to the current opinion that clinical benefit for the patient is at least as important an end-point as objective response rate (ORR) or survival. Clinical benefit response was the primary end-point of this prospective randomised trial in symptomatic, advanced stage IIIB/IV NSCLC, comparing single agent gemcitabine (GEM) to cisplatin-based chemotherapy.

Patients And Methods: Patients received either GEM (1000 mg/m2, days 1, 8 and 15) or cisplatin (100 mg/M2, day 1) plus Vindesine (3 mg/m2, days 1 and 15) (PV), both every four weeks.

Metastatic pleural effusion as presenting sign of prostatic carcinoma.

A patient is reported with symptomatic bilateral malignant pleural effusions as the only and presenting sign of prostatic carcinoma. In view of the excellent response with hormonal therapy, this case illustrates the importance of including prostatic carcinoma into the differential diagnosis of pleural effusions.

Spherocytosis and pulmonary hypertension coincidental occurrence or causal relationship?

A report is given on a 59 yr old man with hereditary spherocytosis and progressive shortness of breath on exertion, due to severe pulmonary hypertension and cor pulmonale. An open lung biopsy was performed in order to exclude all known aetiologies of secondary pulmonary hypertension. Pathological examination revealed in situ thrombosis and asymmetric fibromuscular hyperplasia of small- and medium-sized pulmonary arteries.