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Since calcium (Ca) antagonist enhances the antitumor effect of vinca alkaloid in vitro, The authors attempted to combine nicardipine (Ca antagonist) with vindesine sulfate (VDS) and cis-diammine dichloroplatinum (II)(CDDP) for treatment of two patients with advanced esophageal carcinoma who were considered to be resistant to two courses of combination chemotherapy of VDS and CDDP. In the first case nicardipine was given orally and for only one day at a dose of 60 mg followed by 40 mg two and a half hours later. Thirty minutes after 60 mg of nicardipine, 3 mg of VDS on day 1, and 50 mg of CDDP (repeated for 3 days) were given. The maximum plasma concentration of nicardipine was 834.0 mg/ml, and the patient showed a partial response. In the second case nicardipine was given intravenously at a dose of 10 mg/body/hour for 8 hours which was repeated for 3 days. The same dose of VDS and CDDP as the first case was started the second day. The maximum concentration of nicardipine was 254.3 ng/ml, and this patient did not show any response. These results may suggest that a sufficient plasma concentration of nicardipine would obtained some response even in solid tumors.

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