Chemotherapy and chemopraxis of cancer, 1961.

I t is sobering to reflect that it was a scant 70 years ago when Ehrlich initiated our present chemotherapeutic era by a clinical trial, intravenous methylene blue for malaria, on two patients (38). By present mores, it was a modest venture, indeed; but he started a ball rolling which is still gaining speed and dimension. Many of Ehrlich's ideas, technics, and even the lineal descendants of his compounds permeate cancer chemotherapy today. In Table 1 are listed some cancer chemotherapeutic agents for systemic use and the respective diseases for which a therapeutic result can be expected in a proportion of patients with advanced cancer. Every drug on the list has arrived there in the brief ~0 years since Huggins and Hodges (50) introduced stilbestrol for the treatment of prostatic cancer and thereby sparked the modern era of chemotherapy. Indeed, every other compound on the list has been made only in the past ~0 years, with the exception of testosterone, which in its unesterified form has a long and noble history. They can be categorized as alkylating agents, hormones, antimetabolites, botanicals, antibiotics, and a synthetic compound of uncertain mode of action. The recent additions to this list are cyclophosphamide, which seems to induce less thrombocytopenia at equal levels of leukopenia than other alkylating agents on this list (8~); 17hydroxy-progesterone; 17-N-caproate, the progesrational effect of which has extended the known spectrum of human neoplasms still partially responsive to normal mechanisms of growth regulation (51); desacety]methyleolchicine, which can rapidly decrease the peripheral leukocyte count in chronic myelocytic leukemia (56); and vinblastine sulfate, which has induced responses in Hodgkin's disease no longer responsive to alkylating agents (48, 10~), and choriocarcinoma refractory to methotrexate (47); and o,p'-dichlorodi-