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Cancer Chemother Pharmacol 1987;20:324-6. Thirty-one patients with previously untreated advanced non-small

cell lung cancer were treated with milomycin C (10 mg/m’, day I), vinblastine (5 mg/m2, days 1 and 15), and cisplatin (80 mg/mz, day 1). Combination chemotherapy was repeated al 4-week intervals until disease progression or unacceptable toxicity. The overall response rate was 52.0%, with a median survival time of 8 months. The median duration of response was 16 weeks (range, 7-49 weeks), and 23% of the patients survived for more than 1 year. Toxicity included moderate myelosupprcssion, mild nephropathy, and severe nausea and vomiting. This combination therapy of anticancer agents appears to have antitu- mor activity, but not to have satisfactory therapeutic activity for advanced non-small cell lung cancer.

Retreatment with the induction regimen in small cell lung cancer relapsing after an initial response to short term chemotherapy. Postmus PE, Berendsen HH. Van Zandwijk N, Splinter TAW, Burghouts JTM, Bakker W. Department of Pulmonary Diseases, State University,9713E%Groningen.EurJCancerClin0nco11987;23:1409- Il.

In 37 patients with small cell lung cancer treatment with five cycles of cyclophosphamide, doxorubicin and etoposide (CDE), resulted in 23 complete (CR) and 14 partial responses (PR). Median response duration was34 weeks. A~relapseallpatients weretreated withCDE.In23(62%) patients this gave a second response (6 CR, 17 PR). Factors influencing the occurrence of a second response were: 1. a CR after the first five cycles of CDE; 18 OUI of 23 CR patients responded again whereas only live of the 14 PR patients responded (P < 0.01). 2.15 out of 19 patients with a first response duration > 34 weeks reached a second response and in eight of the other 18 patients retreatment was successful (P < 0.05). Reinduction at relapse, after short term chemotherapy and a treatment- free interval, with the induction regimen is an effective second line treatmen in paticnls with an initial CR and a first response duration of > 34 weeks.

4’-Deoxydoxorubicin, an inactive drug in small cell lung cancer. Giaccone G. Donadio M. Bonardi G. Bagatella M. Calciati A. Division of Medical Oncology, Ospedale S. Giovanni, 10123 Torino. Eur J Cancer Clin Oncol 1987;23: 1407-g.

4’-Deoxydoxorubicin was administered to 27 evaluable patients with refractory small ccl1 lung cancer. The majority of patients had good initial performance status. One third of patients had never received doxorubicin before, and six had received a single drug alone (VM26). Myeloloxlcity waF Lllc main side-effect, and leukopenia was more pronounced than thrombocytopenia. No significant non-hematological toxicity occurred apart from skin necrosis due to drug extravasation in one cast. Two patients had partial response (7.4%; 95% confidence hmi& O-l 7.2%). The low response rate obtained in this good prognosis palicnl population dots not support further testing of this drug in small cell lung cancer.

High dose carboplatin in the treatment of lung cancer and mesothe- lioma: A phase I dose escalation study. Gore M.E. Calvcrt A.H. Smith I.E. The Lung Unit, Royal Marsden Ilospilal, Surlon, Surrey. Eur J Cancer Clin Oncol 1987;23:1391-7.

Sixteen paticnls with lung cancer or mcsothclioma have been treated with escalating doses of carboplatm. Five patients (10 courses) were given 800 mg/m’, four patienti (five courses) 1200 mg/m2 and seven patients (eight courses) 1600 mg/m2. Myclosuppresslon was the major toxicity cncounrcrcd. The median duration of grade 4 neutropcnia ranged from I day (XOa mg/m2) LO 11 days (1600 mg/mz) and the median duration of grade 4 thrombocylopcnia ranged from I day (800 mg/m2)

to 7 days (I600 mg/m”). The median fall in haemoglobin (Hb) ranged from 2.2 g/l (800 mg/m2) to 3.6 @(I600 mg/m*). Nephroloxicity was encountered at all dosages and was in part, though noi entirely, dose related. 2/9 patients rccciving 800 mg/m’ and 4/6 of the patients receiving 1600 mg/m’ had a fall in glomerular f&ration rate (GFR) > 25% but < 50% 800 mg/m2 of carboplatin was well tolerated. the performance status in 9/lO (90%) courses being O-1 (ECOG scale). At 1600 mg/m2 in 6/8 (75%) courses the performance status was 2-4. There wa one lrealmcnl-related death from neutropcnia at this dose Icvel. The scverily ofnauseaand vomiting was notdose related butothertoxicillcs including diarroea, alopecia, mild ncuropathy and ototoxicity and possible CNS toxicity occured at doses of 1200 mg/m* and over. 5/7 patients with small cell lung cancer achieved a complete or partial response to lrcatmcnt.

Carboplatin or iproplatin in advanced non-small cell lung cancer: A cancer and leukemia group B study. Kreisman H, Ginsberg S, Propert KJ, Richards F, Graziano S, Green M. McGill Cancer Center, The Sir Morfimer B. Davis-Jewish General Hospital,Monrreal,Que. Il3Tl.U CancerTrcatRep 1987;71: 1049-52.

The effect of the cisplatin analogos carboplatin (CBIXA) or ipro- plalin (CHIP) was evaluated in palicnls with cxtcnsive non-small cell lung cancer. The randomized phase II design was used to achieve balance between padent groups and comparison of response rates was not a primary objective of the study. CHDCA (400 mg/m2 iv) or CHIP (270 mg/m* iv) was administered every 4 weeks until relapse of disease. Overall, 11 of 70 patients (16%; 95% confidence interval: 7%-25%) responded to CBDCA and five of 71 patients (7%; 95% confidence interval: I%-13%) responded to CHIP. There were IWO complete responses to CHIP and none to CBDCA. The most frequent severe or life-thrcatcning toxic effects were thrombocytopenia and leukopcnia. Median survival for paticnls receiving CBDCA was 6.5 months; for those on CHIP it was 5.0 months (P = 0.59). CBDCA is probably active in patients with non-small cell lung cancer whereas CHIP has limited activity. Further evaluation of CBDCA as part of combination chemo- therapy for non-small lung cancer is warranted.

A phase 11 trial of chlorambucil in non-small cell lung cancer. Gentile PS, Woodcock TM, Blumenreich MS ctal. Division ofMedical Oncology, Department of Medicine, School of Medicine, University of Louisville, Louisville, KY 40292 Am J Clin Oncol, Cancer Clin Trials. 1987;10:515-6.

A Phase II trial of high-dose chlorambucil ai 108 mg/m* was undertaken in non-small cell lung cancer. No complete or partial objective responses wcrc obscrvcd. and significant toxicily, including nausca,vomi~ing,andseizurcs,wasno~cd.Chlorambucila~thisdoscand schedulcofadministration isnotrecommended for thetreatmentofnon- small cell lung cancer.

Etoposidecombination therapy for small cell carcinoma ofthe lung. Abrau RP, Willcox PA, Hewitson RH. Deparrmenr of Radiotherapy. Groote Schuw ffospital, Cape Town. Cancer Chcmother Pharmacol. 1987;20:83-84.

Sixty-three conseculive patients with small cell carcinoma of the lung wcrc ucatcd by six cycles at 3-week intervals of etoposide 120 mg/m* iv. on day 1 and orally on days 2-5, adriamycin 40 mg/mz i.v. on day 1 and vincristine 1.4 mg/m2 i.v. on day 1. Tumour bed irradiation was adminislcrcd to patients with limited disease after chemotherapy. In limilcd-discasc and cxtcnsive-disease patients the median survival was 12 and 6 months rcspcctivcly. The 2-year survival raic (life table) in limit&disease patients was 26%. Treatment morbidity was low. A prospcctivc randomiscd Lrial is being undertaken io further evaluate Ihe role of oral ctoposidc in combination chcmothcrapy.