Adriamycin chemotherapy—efficacy, safety, and pharmacologic basis of an intermittent single high‐dosage schedule

A study designed to correlate clinical and pharmacologic observations was undertaken in 96 patients treated with adriamycin. The basic dosage schedule was 60 mg/m² I.V. q 3 weeks. Pharmacokinetic studies showed a prolonged plasma half‐life, low urinary excretion, and undetectable levels in CSF. Patients with significantly impaired liver function had marked elevation and prolongation of plasma drug levels associated with severe toxicity unless dosage was reduced by 50‐75%. Of the 82 evaluable patients, 10/25 with sarcomas, 9/31 with carcinomas, and 15/26 with hematologic malignancies have achieved complete or partial remission. An additional 22/48 have improved. Six patients with solid tumors had progressive CNS disease while responding systemically. Adriamycin can be used with relative safety and high efficacy in a dosage schedule that resulted from pharmacologic studies. Dosage reduction in patients with liver disease is essential to avoid life‐threatening toxicity.