Edatrexate is related to the standard agent methotrexate and is under study by Ciba-Geigy. It may have a wider spectrum of activity and be more suitable for combinations than the older compound. Major disease targets are lung cancer, head and neck cancers and gynecologic cancer. Combinations with cisplatin , and with leucovorin rescue ( see "Miscellaneous Drugs" ), appear promising.
Epirubicin is one of several second-generation doxorubicin derivatives and is more closely related to it than the other derivatives. It is commercially available in Europe and Canada. The drug is identical to doxorubicin in its actions but differs both in its pharmacology and its potency. A possible advantage for epirubicin is that it reportedly has better tolerance in drug combinations, particularly against breast cancer.
Irinotecan (CPT-11) is a Japanese drug that shows activity against a large number of tumor types, with or without exposure to other drugs. It is in the family of camptothecin derivatives. Toxicities include decreased white blood cell and platelet counts, diarrhea, hair loss, anemia , nausea and vomiting. There have been responses in patients with lung cancer, colon and other gastrointestinal cancers, gynecologic cancers and lymphomas and leukemias. Very active combinations are also being reported. Wide testing of these leads, sponsored by the NCI, is expected in the United States.
