The role that attaining maximum drug dosage intensity plays in many anti-cancer protocols is a major one, particularly in those protocols that attempt to totally eradicate the neoplasm. A classic approach to facilitate this process utilizes stem cell transplants as well as the use of hematopoetic growth factors. However, problems arise with both allogenic and autologous transplants as well as from the significant variability in drug tolerance between individual patients. With average fixed dose protocols, these problems substantially limit the ability to optimize drug dosage. We attempted to circumvent this difficulty by using low dose continuous infusional therapy of variable duration depending upon the patient’s response, together with simultaneous hematopoietic growth factor support. This paper presents our results with three drugs, doxorubicin, ifosphamide, and vinorelbine. With these protocols, we were able to individualize and optimize the amount of drug delivered to each patient, as well as to substantially increase the drug dosage intensity of each of these agents.
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