RESUMEN
BACKGROUND: The carboplatin-based chemotherapeutic regimen M-CAVI (methotrexate, carboplatin, and vinblastine) is active against bladder carcinoma and can be administered to patients who are ineligible to receive cisplatin or doxorubicin. The authors designed a randomized study to evaluate whether M-CAVI offers a therapeutic advantage over the cisplatin-based regimen M-VAC (methotrexate, vinblastine, doxorubicin, and cisplatin) in the treatment of patients with surgically incurable advanced bladder carcinoma. METHODS: Patients with surgically incurable advanced bladder carcinoma were enrolled on a randomized trial comparing M-CAVI, which consists of carboplatin (300 mg/m2 on Day 2, adjusted using Calvert's formula for an area under the curve of 5), methotrexate (30 mg/m2 on Days 1, 15, and 22), and vinblastine (3 mg/m2 on Days 2, 15, and 22) administered every 28 days, versus standard M-VAC. The eligibility criteria included histologically proven bladder carcinoma, surgically incurable disease, and no prior chemotherapy. Patients were treated until disease progression or unacceptable toxicity occurred. RESULTS: From January 1989 to January 1994, 47 assessable patients were included. Seventeen patients had lymph node disease and 30 had distant metastatic disease. Twenty-three patients were randomized to receive M-CAVI and 24 to receive M-VAC. Patient characteristics in the two groups were similar. Overall response rates were 39% (95% confidence interval [CI], 20-62%) for M-CAVI and 52% (95% CI, 30-73%) for M-VAC (P = 0.3), with 3 complete responses observed among patients treated with M-VAC and none among those in the M-CAVI group. M-VAC was associated with more gastrointestinal toxicity, stomatitis, alopecia, and Grade 4 neutropenia than M-CAVI. One toxicity-related death occurred in the M-VAC group. There was a statistically significant difference in median disease-related survival time favoring M-VAC (16 months; range, 6 to 22+) versus M-CAVI (9 months; range, 6 to 14+) (P = 0.03). CONCLUSIONS: M-CAVI is less toxic but less active than M-VAC in the treatment of patients with advanced bladder carcinoma. Carboplatin-based regimens in which carboplatin is administered at the dose range used in the current study should be reserved for patients who cannot tolerate cisplatin treatment. Further research is required to assess the impact of high dose carboplatin in the treatment of this disease.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Adulto , Anciano , Carboplatino/administración & dosificación , Carboplatino/efectos adversos , Cisplatino/administración & dosificación , Cisplatino/efectos adversos , Doxorrubicina/administración & dosificación , Doxorrubicina/efectos adversos , Femenino , Humanos , Masculino , Metotrexato/administración & dosificación , Metotrexato/efectos adversos , Persona de Mediana Edad , Estudios Prospectivos , Resultado del Tratamiento , Neoplasias de la Vejiga Urinaria/mortalidad , Vinblastina/administración & dosificación , Vinblastina/efectos adversosRESUMEN
Carboplatin, methotrexate, and vinblastine (M-CAVI) is an active and well-tolerated regimen for bladder cancer patients ineligible for cisplatin-based regimens. We treated 47 T2-4 N0 M0 bladder cancer patients with M-CAVI in a neoadjuvant phase II trial. These 47 patients are evaluable for clinical response and toxicity. Clinical overall response rate was 34%, for a 95% confidence interval (CI95%) of 21-49%. Pathological response was seen in 40% of the patients (CI95%, 26-56%) with a 26.5% rate of pathological complete response (CI95%, 15-42%). Factors associated with the achievement of a response to therapy were the initial TNM stage (pT3a or lower, greater than pT3a, p = 0.001) and a Karnofsky score greater or equal than 90%, which was marginally significant (p = 0.08). With a median follow-up of 14 months, the disease-specific actuarial survival at 2 years is 42%. No patient has relapsed beyond 21 months of follow-up in a disease-free status. Toxic effects have been moderate. In conclusion, M-CAVI is an active and well-tolerated regimen that should be compared in terms of response rate and survival with a cisplatin-based regimen for invasive bladder cancer.
Asunto(s)
Antimetabolitos Antineoplásicos/administración & dosificación , Antineoplásicos Fitogénicos/administración & dosificación , Antineoplásicos/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carboplatino/administración & dosificación , Carcinoma de Células Transicionales/tratamiento farmacológico , Metotrexato/administración & dosificación , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Vinblastina/administración & dosificación , Análisis Actuarial , Adolescente , Adulto , Anciano , Quimioterapia Adyuvante , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Estado de Ejecución de Karnofsky , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Estadificación de Neoplasias , Inducción de Remisión , Tasa de SupervivenciaRESUMEN
BACKGROUND: Tegafur is an antimetabolite slowly metabolized to 5-fluorouracil in vivo. Protracted administration of oral tegafur is active in metastatic breast cancer, with reported response rates ranging from 29 to 44%. The addition of folinic acid could improve the efficacy of tegafur by means of biochemical modulation. METHODS: A prospective Phase II trial in patients with pretreated metastatic breast cancer was performed. The regimen consisted of oral tegafur (750 mg/m2/day) and oral folinic acid (45 mg/day) for 21 days, recycling at day 28. RESULTS: Twenty-five patients were included. Eight partial responses were observed for an objective response rate of 32% (95% confidence intervals for response, 23-41%). The median duration of response was 7 months. According to WHO criteria, 24% of patients experienced grade 3 mucositis and 12% grade 3 diarrhea, but no other significant toxicities were observed. Twenty-eight percent of patients required dose reductions for toxicity. CONCLUSIONS: A significant response rate with oral tegafur and folinic acid in patients with heavily pretreated breast cancer was found. This all-oral regimen, which could be safely administered on an outpatient basis, deserves further evaluation to define the role of folinic acid on the activity of tegafur in metastatic breast cancer.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Administración Oral , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias de la Mama/patología , Diarrea/inducido químicamente , Humanos , Leucovorina/administración & dosificación , Leucovorina/efectos adversos , Persona de Mediana Edad , Mucosa Bucal , Metástasis de la Neoplasia , Estudios Prospectivos , Inducción de Remisión , Estomatitis/inducido químicamente , Tegafur/administración & dosificación , Tegafur/efectos adversosRESUMEN
We identified 40 patients with malignant lymphoproliferative diseases (MLD) and HIV infection (seropositive) at a single Spanish university hospital. Thirty-two patients had non-Hodgkin's lymphoma (NHL), 6 primary central nervous system lymphoma (PCL) and 8 patients Hodgkin's disease (HD). Median age at presentation was 32 years. Four histopathological groups had distinct presenting clinical features: in 93% of the Burkitt-type lymphomas, the lymphoma itself was the AIDS defining criterion, while high and intermediate grade NHL other than Burkitt-like tended to have a more advanced HIV infection, demonstrated by antecedent AIDS criteria in 58% of these patients and a median CD4 positive cell count of 291 mm3; HD occurred in some patients without previous opportunistic infections (7/8 patients) but with median CD4 cells of 105 mm3; PCL occurred in a terminal stage of HIV infection, in patients with a low performance status, and frequent antecedent AIDS criteria. Objective response to chemotherapy could be seen in 62% of NHL patients and 100% of HD. Survival was adversely related to an antecedent diagnosis of AIDS, low performance status, and a primary localization in the central nervous system. Overall median survival was 5 months, but patients without the mentioned three adverse prognostic factors had a median survival of 10 months.
Asunto(s)
Seropositividad para VIH/complicaciones , Trastornos Linfoproliferativos/virología , Análisis Actuarial , Adolescente , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Recuento de Linfocito CD4 , Femenino , Seropositividad para VIH/inmunología , Humanos , Trastornos Linfoproliferativos/tratamiento farmacológico , Trastornos Linfoproliferativos/inmunología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , España , Análisis de SupervivenciaRESUMEN
We analyzed the series of 40 malignant lymphoproliferative diseases (MLD) in HIV positive patients, diagnosed between 1986 and 1993 in a University Hospital in Spain. Median age was 32 years. 52% of the patients belonged to the intravenous drug users risk group, and 30% were homosexual. 26 patients were diagnosed of a non-Hodgkin's lymphoma (NHL), 8 of Hodgkin's disease (HD) and 6 of a primary central nervous system lymphoma (PCL). The 6 patients with a PCL (median CD4 of 20 cells/mm3, 80% antecedent AIDS criteria) and 13 NHL with histology of immunoblastic, large cell, plasmablastic, and high grade lymphoma non-otherwise specified (median CD4 of 291, 58% with AIDS criteria) tended to appear in patients with a deteriorated clinical and immunological status due to the underlying HIV infection. However, the 14 small non-cleaved cell NHLs appeared in patients without a previous AIDS-defining condition (93% of the cases, p = 0.065 compared with other NHL histologies). Finally, 8 patients with HD had a low CD4 cell count (median 103 cells/mm3, p = 0.049 compared with median CD4 in NHL patients) without other previous AIDS criteria. In conclusion, The presenting characteristics of HIV positive patients with MLD allows to define four subgroups of patients with a high clinicopathological correlation.
Asunto(s)
Seropositividad para VIH/fisiopatología , Linfoma Relacionado con SIDA/fisiopatología , Adolescente , Adulto , Neoplasias del Sistema Nervioso Central/fisiopatología , Femenino , Enfermedad de Hodgkin/fisiopatología , Humanos , Linfoma/fisiopatología , Linfoma no Hodgkin/fisiopatología , Masculino , Persona de Mediana EdadRESUMEN
The degradation of carboplatin (3.2 mg ml-1) in 5% glucose infusion solution at 25 degrees C and protected from light was investigated. The effects of the material of the container and temperature were also studied. Solutions were prepared in 5% glucose solution and stored in glass bottles, polyethylene (PE) and polypropylene (PP) containers at 40, 50 and 60 degrees C and at 25 degrees C +/- 1 degrees C. Samples were assayed by an HPLC method to determine the residual carboplatin concentration at each time of sampling. Carboplatin degradation followed pseudo-first-order kinetics and no dependence on the nature of the container was found. After 1 month at 25 degrees (+/- 1 degrees)C the change in carboplatin concentration was < 2% of the initial concentration in 5% glucose. These results are in agreement with those predicted by the application of the Arrhenius equation.
Asunto(s)
Carboplatino/química , Embalaje de Medicamentos , Cromatografía Líquida de Alta Presión , Estabilidad de Medicamentos , Almacenaje de Medicamentos , Vidrio , Glucosa/química , Cinética , Polietilenos , Polipropilenos , TemperaturaRESUMEN
Primary non Hodgkin's lymphoma of the breast (PNHLB) its an unusual presenting form of malignant breast diseases. Its estimated frequency is around 0.05-0.5% of all breast tumors. Three cases of PNHLB are presented. We analyse the characteristics of presenting features and also we discuss the therapeutic and prognostic implications. They can be initially confused with a typical breast carcinoma due to the unspecific clinical findings with the difficulty to obtain a definitive diagnosis based only on cytologic grounds. The therapeutic and prognostic consequences underlines the importance of immunohistochemistry in the diagnosis of PNHLB.
Asunto(s)
Neoplasias de la Mama/patología , Linfoma no Hodgkin/patología , Adulto , Anciano , Carcinoma/patología , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana EdadRESUMEN
BACKGROUND: A Phase II trial with a new regimen of methotrexate, carboplatin, and vinblastine (M-CAVI) was conducted for patients with bladder cancer who could not receive cisplatin-based chemotherapy. METHODS: Treatment consisted of methotrexate (30 mg/m2) on days 1, 15, and 22; carboplatin (300 mg/m2) on day 2; and vinblastine (3 mg/m2) on days 2, 15, and 22, scheduled at 28-day intervals. The dosage of carboplatin was adjusted for creatinine clearance. Twenty-five patients with metastatic (n = 9) or locally advanced or locoregional bladder cancer with a poor prognosis (n = 16) were treated with M-CAVI. Fifteen patients had abnormal serum creatinine levels, 4 had a low performance status, 3 had cardiac disease, and 3 were older than 70 years old. RESULTS: Among 23 patients assessable for clinical response, the response rate was 48%. The median duration of response for metastatic disease was 7 months. Among nine patients assessable for pathologic response, there were two complete responses and three partial responses. The toxic effects have been moderate. CONCLUSIONS: M-CAVI is an active and well-tolerated regimen that can be used in patients with bladder cancer who are ineligible to receive cisplatin-based chemotherapy.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Adulto , Anciano , Carboplatino/administración & dosificación , Cisplatino/efectos adversos , Terapia Combinada , Evaluación de Medicamentos , Femenino , Humanos , Masculino , Metotrexato/administración & dosificación , Persona de Mediana Edad , Análisis de Supervivencia , Neoplasias de la Vejiga Urinaria/cirugía , Vinblastina/administración & dosificaciónRESUMEN
Metastatic disease is the first clinical manifestation of differentiated thyroid carcinoma (DTC) in less than 5% of cases. Bone metastases as the first sign of DTC are associated with a poor prognosis, both for being resistant to treatment and for complications due to them. Spinal cord compression is a rare development in DTC, which may present late in the course of the disease. An initial presentation of DTC with a spinal cord compression is an extremely rare condition.
Asunto(s)
Adenocarcinoma/secundario , Vértebras Cervicales , Compresión de la Médula Espinal/etiología , Neoplasias de la Columna Vertebral/secundario , Neoplasias de la Tiroides/diagnóstico , Adenocarcinoma/diagnóstico , Anciano , Femenino , Humanos , Neoplasias de la Columna Vertebral/diagnósticoRESUMEN
Cyclophosphamide is used both in the treatment of malignant and non-malignant diseases. Urinary neoplasms secondary to its use have been described. We discuss the case of a patient with panarteritis nodosa treated with cyclophosphamide during 63 months, with a total dose of 210 grams, and that showed a bladder neoplasm 8 years after beginning of the treatment. In patients receiving a total dose of cyclophosphamide over 85 grams, a follow-up of ten years minimum should be performed aimed to the early detection of secondary neoplasms.
Asunto(s)
Ciclofosfamida/efectos adversos , Recurrencia Local de Neoplasia/inducido químicamente , Papiloma/inducido químicamente , Poliarteritis Nudosa/complicaciones , Neoplasias de la Vejiga Urinaria/inducido químicamente , Corticoesteroides/uso terapéutico , Anciano , Neoplasias Óseas/secundario , Ciclofosfamida/administración & dosificación , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada , Humanos , Neoplasias Pulmonares/secundario , Masculino , Recurrencia Local de Neoplasia/cirugía , Papiloma/cirugía , Poliarteritis Nudosa/tratamiento farmacológico , Factores de Tiempo , Neoplasias de la Vejiga Urinaria/cirugíaRESUMEN
The results obtained from 23 patients suffering small cell lung carcinoma limited to the thorax, treated with 4 cycles of cyclophosphamide, adriamycin, vincristine alternating with cisplatin and VP/16, followed by mediastinal and holocranial prophylactic radiotherapy in patients with a complete response (CR) are here presented. An 87% of global responses were obtained with a 64% rate of RC. The average survival rate was 12 months with an 18% of patients alive two years after treatment. The main toxicity was hematologic and neurologic. Even if this alternating regime produces a high response rate, the results are not superior to those obtained with conventional chemotherapy.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Células Pequeñas/tratamiento farmacológico , Neoplasias Pulmonares/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Carcinoma de Células Pequeñas/mortalidad , Carcinoma de Células Pequeñas/radioterapia , Cisplatino/administración & dosificación , Cisplatino/efectos adversos , Terapia Combinada , Ciclofosfamida/administración & dosificación , Ciclofosfamida/efectos adversos , Doxorrubicina/administración & dosificación , Doxorrubicina/efectos adversos , Etopósido/administración & dosificación , Etopósido/efectos adversos , Humanos , Lomustina/administración & dosificación , Lomustina/efectos adversos , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/radioterapia , Metotrexato/administración & dosificación , Metotrexato/efectos adversos , Procarbazina/administración & dosificación , Procarbazina/efectos adversos , Inducción de Remisión , Factores de Tiempo , Vincristina/administración & dosificación , Vincristina/efectos adversosRESUMEN
We treated 19 patients previously exposed to anthracyclines (progression during therapy or after discontinuation of therapy) with ifosfamide (IFO) 2 g/m2 i.v. in a 1-h infusion daily for 3 days with mesna uroprotection and mitoxantrone (MZT) 12 mg/m2 on day 1 of every 3-week cycle. The response rate was assessed after two cycles. A response to treatment was observed in 6 of 15 evaluable patients (40%), with no complete remission and 6 partial remissions. The median duration of response was 6+ months (3+ to 12+). The toxicity was acceptable, with three episodes of grade 3-4 myelosuppression (8%) and one case of congestive heart failure resulting from a fluid overload that responded to medical treatment. The IFO-MZT combination is an effective second-line regimen in advanced breast cancer previously treated with anthracyclines.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Doxorrubicina/uso terapéutico , Ifosfamida/administración & dosificación , Mitoxantrona/administración & dosificación , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Femenino , Humanos , Persona de Mediana EdadRESUMEN
Capillary microscopy is an easy, noninvasive procedure to examine in vivo the dermis capillaries of the nailfold. It has demonstrated clinical use in the etiologic study of Raynaud's phenomenon. We consider a "vascular activity pattern" to be present at capillary microscopy when one of the following associations is observed: tortuous capillary vessels plus ramifications with or without loss of a moderate amount of capillaries. Capillary tortuousity alone is not considered pathologic. It is well known that bleomycin (BLEO) can occasionally induce vascular-associated diseases. To examine the vascular damage produced by BLEO, we performed capillary microscopic studies on 40 patients with neoplasia, 21 of whom had received BLEO during the previous year. The maximum accumulated doses ranged from 15 to 379 U. The other 19 patients had advanced neoplasia, and 10 of them had received antitumoral combinations that did not contain BLEO. No one had clinical signs attributable to vascular toxicity. Twenty-six patients had no pathologic patterns (11 received BLEO and 15 did not). In the group of 14 patients with activity patterns, 10 had received BLEO and 4 had not (P = 0.035). Ten of 11 patients treated with BLEO who had normal capillary microscopic studies received total doses of less than 100 U. We conclude that capillary microscopy may demonstrate the vascular damage induced by BLEO even in asymptomatic patients.
Asunto(s)
Bleomicina/efectos adversos , Microscopía/métodos , Uñas/irrigación sanguínea , Enfermedades Vasculares/inducido químicamente , Capilares/efectos de los fármacos , Humanos , Neoplasias/tratamiento farmacológico , Enfermedades Vasculares/diagnósticoRESUMEN
A case of palmar-plantar erythrodysesthesia syndrome (PPES) observed during a 120-h infusion of 5-fluorouracil (5-FU) is presented. This syndrome has been described in the literature after protracted infusion chemotherapy of over 30 days. The agent most frequently associated with this syndrome was 5-FU. A 53-year-old man was admitted to the hospital with a well-differentiated squamous cell carcinoma of the retromolar trigone. The patient received 100 mg/m2 of cisplatin on day 1 and 120-h continuous infusion of 1000 mg/m2 of 5-FU every 3 weeks. After the second course, the patient developed clinical features consistent with PPES. This side effect has not been previously reported with short-term (5-day or 120-h) continuous infusion of 5-FU. Less frequently, the syndrome has also been described with 10-day continuous infusion. The etiopathogenesis of PPES is unclear, but it seems to be dose-dependent and probably related to cutaneous drug accumulation.
Asunto(s)
Eritema/inducido químicamente , Fluorouracilo/efectos adversos , Parestesia/inducido químicamente , Carcinoma de Células Escamosas/tratamiento farmacológico , Fluorouracilo/uso terapéutico , Pie , Mano , Humanos , Masculino , Persona de Mediana Edad , Síndrome , Factores de TiempoRESUMEN
A new antigen associated with breast cancer, CA 15.3, was determined in the serum of 690 breast cancer patients and controls. After establishing a maximum normal level of 40 U/ml in 140 healthy subjects and 350 patients with benign diseases, CA 15.3 was investigated in 190 breast cancer patients: CA 15.3 serum levels were statistically different in patients with no evidence of disease (20.6 +/- 11.2 U/ml), metastatic patients in response (33.5 +/- 24.0 U/ml) and metastatic patients not responding to therapy (stable disease, 98.9 +/- 50.4; progression, greater than 200). CA 15.3 serum levels seem to correlate with the extent of metastatic breast cancer. Further studies are needed to establish the role of this marker in the management of breast cancer patients.
Asunto(s)
Antígenos de Neoplasias/análisis , Neoplasias de la Mama/inmunología , Antígenos de Carbohidratos Asociados a Tumores , Neoplasias de la Mama/terapia , Femenino , HumanosRESUMEN
CA 15.3 is an antigen expressed by human breast carcinoma cells, and defined by two monoclonal antibodies, 115D8 and DF3. We used IRMA to determine the circulating serum levels of CA 15.3 in 1178 subjects with breast cancer, non-breast malignancies, benign diseases and controls. A threshold level of 40 U/ml was established with 140 healthy controls and 650 patients with benign diseases (respectively 0% subjects and 1.5% patients had abnormal antigen levels). Elevated CA 15.3 was found in 12 of 184 patients with malignancies different from breast cancer (6.5%), either epithelial carcinomas with distant metastases, mainly in the liver, or primary liver tumors. Breast cancer patients (n = 204) were analysed by prior therapy, UICC stage and WHO response to therapy. Eight of 134 (5.9%) patients with stage II or III breast cancer at presentation and no evidence of disease (NED) had elevated CA 15.3. All of 22 patients with stage IV breast cancer not responding to therapy (SD and PD) had antigen levels greater than 40 U/ml, as did 10 of 34 (29.4%) stage IV patients in objective response (CR + PR). Three of 14 pretreatment patients had abnormal marker levels, and they later proved to have distant metastases. Serum CA 15.3 values were statistically different (p less than 0.01) in NED (20.6 +/- 11.2 U/ml), CR + PR (33.5 +/- 24.0 U/ml), stable disease (98.8 +/- 50.4 U/ml) and progressive disease (greater than 200 U/ml) breast cancer patients. Our results suggest that circulating CA 15.3 antigen levels agree with the stage of breast cancer and with the response to therapy.
Asunto(s)
Antígenos de Neoplasias/análisis , Biomarcadores de Tumor/sangre , Neoplasias de la Mama/inmunología , Adulto , Anciano , Antígenos de Carbohidratos Asociados a Tumores , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/inmunología , Valores de ReferenciaRESUMEN
In order to know the behavior of the tissue polypeptide antigen (TPA) as a tumor marker, the authors determine its amount in serum by means of radioimmunoassay (TPA Prolifigen RIA) in 441 patients having respiratory, digestive, urogenital, hematopoietic, mammary and other malignant tumors. The obtained results indicate that: TPA has no tumor specificity; however it increases in tumors without any other known tumor marker. TPA has no diagnostic value, but it is useful for the following up of digestive, mammary, respiratory, ovarian and testicular cancer; amounts of TPA comprised between 90 and 120 U/l are not specific and have no clinical significance; and it is very useful the simultaneous determination of CEA and TPA in the respiratory, digestive and mammary malignant neoplasms to help the clinical data in the evaluation of tumor mass (CEA) and tumor activity (TPA) without indication of tumor localization.