cisplatin and vinblastine as induction chemotherapy in advanced nsclc subsequently treated with...

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115 Toxicity was mild (median WBC nadir 3.000/mm- for "high" C+E, 3.600 for "low" C+E, 3.300 for C+V). Although no signifi- cant difference exists as for remission ra- te, we showed a significant difference of survival in favour of "high" C+E vs. "low" C+E or C+V. Comparison of Vindesine Plus Cisplatin or Mytomycin C in The Treatment of Advanced Non-Small Cell Lung Cancer. 8aijo, N., Shinkai, T., Sasaki, Y., Eguchi, K., Tominaga, K., Fujita, J., Futami, H. Department of Internal Medicine, National Cancer Center, Tokyo, Japan. Fifty-eight patients with advanced non- small cell lung cancer were random½Y allo- cated to receive vindesine (3 mg/m ~very week) plus either cisplatin (80 mg~m eve- ry 21 days) or mitomycin C (8 mg/m every week). No patient achieved a complete response. Among the 28 patients treated with vindesine plus cisplatin, there were 12 partial responders (42.9%), and among 30 patients treated with vindesine plus mitomycin C, there were three partial re- sponders (10%). The median duration of re- sponse was 11.5 wks (range 4-25) in the patients treated with vindesine plus cis- platin. The median survival times for the 28 patients treated with vindesine plus cisplatin and for the 30 patients treated with vindesine plus mitomycin C were 9.2 and 10.4 months, respectively. In patients treated with vindesine plus cisplatin, the median survival times for the 12 respon- ders and for the 16 non responders were 8.3 and i0.0 months, respectively, and there was no significant difference in survival time between responders and non responders. Toxic effects, including moderate myelo- suppression, nephrotoxicity, peripheral neuropathy, and gastrointestinal symptoms, were manageable in general. The combina- tion of cisplatin and vindesine appears to be effective against advanced non-small cell lung cancer. Cisplatin and Vinblastine as Induction Che- motherapy in Advanced NSCLC Subsequently Treated with Cytoxan, Adriamycin and Mitomycin-C. Salvati, F., Cruciani, A. R., Mugnaini, L., De Marinis, A., Antilli, A., Moliica, C., Orazi, D., Conte, S., Signora, M. 8th Department of Pneumology "Forlanini" Hospi- tal, 00149 Rome, Italy. Although a little progress carried out in responses of NSCLC using cisplatin in combined chemotherapy, both survival and duration of response remain unsatisfac- tory. In order to improve such results we treated, from December 1983 to November 1984, 28 evaluable pts administering ini- tially combined induction chemotherapy with c~splatin i00 mg/m2i.v, plus vinblastine 6 mg/m i.v. day 1 every 28 days for 3 courses; after 4 wee~s the pts received cyclophosp~ami- de 500 mg/m- i.v. plusgadr&~mycin 50 mg/m- i.v. and mitomycin-C 7 mg/m- i.v. day 1 every 5 weeks until progression. The median age resul- ted in 59 years (range 37-73) and P.S. 0-i ac- cording to Zubrod scale. No patient was previ- ously treated with chemotherapy and/or radio- therapy. The TNM stage of disease was III M 0 in 22 pts and III M. in 6 pts. For evaluation i of the response were followed the WHO criteria. The results observed at present are the follo- wing: i0 pts reached complete + partial respon- se (CR + PR = 35.7%) with MST of 12+, 5 months (range 5+-14+); 12 pts remain in stable dis- ease (SD = 42,8%) with MST of 7 months (range 3-14+); finally 6 pts had progression of dis- ease (P = 21,5%) with MST of 4 months (range 3-5). The median duration of response resulted in 3,5 months. These data indicate that the chemotherapeutic regimen we tried is encoura- ging: further follow-up needs. ~hase II Study of Vindesine, CCNU, Cis-Plati- num and Cyclophosphamide (VCPC) in Advanced Adenocarcinoma of the Lung. Le Chevalier, T., Piva, F., Arriagada, R., Spielmann, M., Baldeyrou, P., Rouesse, J.:In- stitut Gustave Roussy, Villejuif, France. Adenocarcinoma of the lung (ACL) often pre- sent with metastases at time of diagnosis. From 1980 to 1984, we have treated patients with advanced ACL with a combined chemotherapy i~cluding vind~sine 1.5 mg/m ~ dl; CC~U 50 mg/ m- d2, 25 mg/m ~ d3; ~is DDP I00 mg/m--d3; cyclo- phosphamide 200 mg/m- d2, 3, 4 (VCPC) given monthly. Patients were evaluated 3 weeks after the 2nd cycle and VCPC was continued in respon- ders and in patients with stable disease. Thirty five men and five women with a median age of 53 years (range 30-70) received two or more cycles. Nine patients had a locally advan- ced ACL and 31 had disseminated disease at time of inclusion. Median performance status (P.S.) was 70% (range 50-70%) and no patient had received pre- vious chemotherapy. Eleven patients presented a response > 50% (27.5%), 8 patients presen- ted a response < 50% (20%), i0 patients had a stable disease (25%) and ii progressed (27.5%) Among patients with locally advanced ACL, 2 presented a response > 50%, 2 a response < 50%, 2 a stabilization and 3 progressed. Median number of cycles was 3 (range 2-10). No major side effect was seen: nausea and vomi- ting were treated symptomatically; hematologic toxicity was acceptable and there was no renal failure. Median survival is 8 months (range 2+ - 36+). The results obtained in advanced ACL are less effective and those obtained in squamous cell lung carcinoma with VCPC but the initial "P.S." may explain our results.

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Page 1: Cisplatin and vinblastine as induction chemotherapy in advanced NSCLC subsequently treated with cytoxan, adriamycin and mitomycin-C

115

Toxicity was mild (median WBC nadir 3.000/mm- for "high" C+E, 3.600 for "low"

C+E, 3.300 for C+V). Although no signifi- cant difference exists as for remission ra- te, we showed a significant difference of survival in favour of "high" C+E vs. "low" C+E or C+V.

Comparison of Vindesine Plus Cisplatin or Mytomycin C in The Treatment of Advanced Non-Small Cell Lung Cancer. 8aijo, N., Shinkai, T., Sasaki, Y., Eguchi, K., Tominaga, K., Fujita, J., Futami, H. Department of Internal Medicine, National Cancer Center, Tokyo, Japan.

Fifty-eight patients with advanced non- small cell lung cancer were random½Y allo- cated to receive vindesine (3 mg/m ~very week) plus either cisplatin (80 mg~m eve- ry 21 days) or mitomycin C (8 mg/m every week). No patient achieved a complete response. Among the 28 patients treated with vindesine plus cisplatin, there were 12 partial responders (42.9%), and among 30 patients treated with vindesine plus mitomycin C, there were three partial re- sponders (10%). The median duration of re- sponse was 11.5 wks (range 4-25) in the patients treated with vindesine plus cis- platin. The median survival times for the 28 patients treated with vindesine plus cisplatin and for the 30 patients treated with vindesine plus mitomycin C were 9.2 and 10.4 months, respectively. In patients treated with vindesine plus cisplatin, the median survival times for the 12 respon- ders and for the 16 non responders were 8.3 and i0.0 months, respectively, and there was no significant difference in survival time between responders and non responders. Toxic effects, including moderate myelo- suppression, nephrotoxicity, peripheral neuropathy, and gastrointestinal symptoms, were manageable in general. The combina- tion of cisplatin and vindesine appears to be effective against advanced non-small cell lung cancer.

Cisplatin and Vinblastine as Induction Che- motherapy in Advanced NSCLC Subsequently Treated with Cytoxan, Adriamycin and Mitomycin-C. Salvati, F., Cruciani, A. R., Mugnaini, L., De Marinis, A., Antilli, A., Moliica, C., Orazi, D., Conte, S., Signora, M. 8th Department of Pneumology "Forlanini" Hospi- tal, 00149 Rome, Italy.

Although a little progress carried out in responses of NSCLC using cisplatin in combined chemotherapy, both survival and duration of response remain unsatisfac- tory. In order to improve such results we treated, from December 1983 to November 1984, 28 evaluable pts administering ini- tially combined induction chemotherapy

with c~splatin i00 mg/m2i.v, plus vinblastine 6 mg/m i.v. day 1 every 28 days for 3 courses; after 4 wee~s the pts received cyclophosp~ami- de 500 mg/m- i.v. plusgadr&~mycin 50 mg/m- i.v. and mitomycin-C 7 mg/m- i.v. day 1 every 5 weeks until progression. The median age resul- ted in 59 years (range 37-73) and P.S. 0-i ac- cording to Zubrod scale. No patient was previ- ously treated with chemotherapy and/or radio- therapy. The TNM stage of disease was III M 0 in 22 pts and III M. in 6 pts. For evaluation

i of the response were followed the WHO criteria. The results observed at present are the follo- wing: i0 pts reached complete + partial respon- se (CR + PR = 35.7%) with MST of 12+, 5 months (range 5+-14+); 12 pts remain in stable dis- ease (SD = 42,8%) with MST of 7 months (range 3-14+); finally 6 pts had progression of dis- ease (P = 21,5%) with MST of 4 months (range 3-5). The median duration of response resulted in 3,5 months. These data indicate that the chemotherapeutic regimen we tried is encoura- ging: further follow-up needs.

~hase II Study of Vindesine, CCNU, Cis-Plati- num and Cyclophosphamide (VCPC) in Advanced Adenocarcinoma of the Lung. Le Chevalier, T., Piva, F., Arriagada, R., Spielmann, M., Baldeyrou, P., Rouesse, J.:In- stitut Gustave Roussy, Villejuif, France.

Adenocarcinoma of the lung (ACL) often pre- sent with metastases at time of diagnosis.

From 1980 to 1984, we have treated patients with advanced ACL with a combined chemotherapy i~cluding vind~sine 1.5 mg/m ~ dl; CC~U 50 mg/ m- d2, 25 mg/m ~ d3; ~is DDP I00 mg/m--d3; cyclo- phosphamide 200 mg/m- d2, 3, 4 (VCPC) given monthly. Patients were evaluated 3 weeks after the 2nd cycle and VCPC was continued in respon- ders and in patients with stable disease.

Thirty five men and five women with a median age of 53 years (range 30-70) received two or more cycles. Nine patients had a locally advan- ced ACL and 31 had disseminated disease at time of inclusion.

Median performance status (P.S.) was 70% (range 50-70%) and no patient had received pre- vious chemotherapy. Eleven patients presented a response > 50% (27.5%), 8 patients presen- ted a response < 50% (20%), i0 patients had a stable disease (25%) and ii progressed (27.5%) Among patients with locally advanced ACL, 2 presented a response > 50%, 2 a response < 50%, 2 a stabilization and 3 progressed.

Median number of cycles was 3 (range 2-10). No major side effect was seen: nausea and vomi- ting were treated symptomatically; hematologic toxicity was acceptable and there was no renal failure. Median survival is 8 months (range 2+ - 36+).

The results obtained in advanced ACL are less effective and those obtained in squamous cell lung carcinoma with VCPC but the initial "P.S." may explain our results.