The Use of Atabrine (Quinacrine) in the Control of Recurrent Neoplastic Effusions

A PRELIMINARY REPORT

¹ The Medical Service, Francis Delafield Hospital, and the Departments of Medicine and Biochemistry, College of Physicians and Surgeons, Columbia University.
² Clinical Cancer Research Trainee, National Cancer Institute, United States Public Health Service., The Medical Service, Francis Delafield Hospital, and the Departments of Medicine and Biochemistry, College of Physicians and Surgeons, Columbia University.
³ Established Investigator, Health Research Council, City of New York., The Medical Service, Francis Delafield Hospital, and the Departments of Medicine and Biochemistry, College of Physicians and Surgeons, Columbia University.

In this preliminary report evidence has been presented which demonstrates that Atabrine (quinacrine) is effective in controlling neoplastic effusions. The number of cases available thus far for evaluation is too small to permit an accurate statement of the frequency of success. It would appear likely, however, that since the drug has a definite cytotoxic effect on tumor cells and also produces a serositis, it will control effusions with reasonable regularity.

The side reactions of fever, local discomfort and, rarely, yellow pigmentation (1 case) are not real hazards and probably will be reduced in frequency with the modified dosage regimen suggested in this paper. The potentially more serious compromise of lung volume by contraction of the fibrous tissue in the pleura must be weighed in patients with reduced ventilatory capacity. The ready availability of Atabrine, its low cost, apparent effectiveness against a variety of tumor types, and absence of significant systemic toxicity commend the drug for trial in the management of neoplastic effusions. It is to be reemphasized, however, that this treatment, at best, offers relief of a symptom and will not fundamentally modify the natural history of the underlying neoplastic disease.