[Side effects of peplomycin]

Twenty-three patients with squamous cell carcinoma were treated with a combination chemotherapy consisting of cisplatin, vincristine, and peplomycin. Overall response rate was over 70% including complete disappearance of tumors in one patient. Peplomycin was given by continuous i.v. or s.c. infusion using a micro-infusion pump. All the patients experienced some degree of nausea, vomiting, and hair loss. Phlebitis and induration of injection sites with subsequent local pigmentation were frequently encountered. Nausea and vomiting were caused mainly by cisplatin, but more than 60% of the patients experienced transient increase of anorexia or nausea in the period of peplomycin administration. Eruption with skin excoriation or pigmentation along scratch dermatitis were seen in 5 patients. These side effects were well tolerated, and high fever which is commonly observed in one-shot therapy did not develop in any patient. Pulmonary fibrosis was also not seen. Peplomycin should be given by low-dose continuous infusion because of its low toxicity and comparable antineoplastic activity to one-shot therapy.