Abstracts/Lung Cancer 10 (1994) 395-430 425

(SCLC) remains a high priority for clinical investigators. Recently, 2 very different approaches have been used to evaluate new agents in this di-. Some groups have opted to test new agents in previously untreslted patients with extensive-stage SCLC, and the second approach is to continue to t& new agents only in previously treated patients. Regardless of which method is used. it appears that new-agent activity can be assessed in either previously treated or untreated SCLC patients without compromising the therapeutic gains of the past 2 decades, provided proper patient selection guidelines are employed.

New directions for chemotherapy in non-small-cell lung cancer Green MR. Depumnenr of Medicine, San Diego School of Medicine, Universiryof California. San Diego, CA. Chest 1993;103:Suppl. 37OS- 2s.

Currently, only a few chemotherapeutic agents (ifosfamide. mitomycin. vinblastine. and vindesiae) have consistently produced single-agent reqonse rates greater than 1.5 46 in patients with non-small- cell luagcancer(NSCLC). Whilecombinationchemotherapywiththese and other agents may prolong survival in some patients with advanced disease. complete responses and long- term disease control arc achieved only infrequently. In recent years, several new drugs have produced single-agent response rates above 20% in phase I/II trials. These results have brightened the prospects for chemotherapy against NSCLC. This artzle reviews available data for several of these agents: aavelbine, which is an malogue of vinblastine, the camptothecins CTP-1 I and topotecan. and taxol, the tirst of a novel class of antimicrotubule drugs.

Phase I/II trial of etoposide and carboplatin in extensive small-cell lung cztncer Luikart SD, Goutsou M. Mitchell ED, Van Echo DA, Modeas CR, Propert KJ et al. University of Minnesota. Medical School, Box 325. Mineapolir, MN55455. AmJClinOncolCancerClinTrials 1993;16: 127- 31.

Previouslyuntreatedextensivesmall-celllungcancer(SCLC)patients with pzrformancr statuso-2 were treated with etoposide 200 mg/mQay on days 1-3 and carboplatin doses of SO, 100, or 125 mg/&/day on days l-3 in a Phase I format. Among the ten eligible patients treated with I25 mg/mz/day of carboplatin. grade 3 or 4 infection occurred in six patients, grade 4 thrombocytopenia in four patients, and there was one death with myelosuppression. Thus, this dose was considered the maximum tolerated dose (MTD), and a Phase II trial was then conducted uttliziag this treatment program. In the Phase II trial. 81% of the 48 eligible patients had grade 3 or 4 leukopenia, 76% had grade 3 or 4 thrombocytopenia. and 55 46 had grade 3 or 4 anemia. There were three (6 %) toxic deaths from myelosuppre&on. The objective response rate was 63 96 (17 56 complete responders) with a median response duration of 6.2 months for complete responders and 6.4 months for partial responders. Median survival was 12 months. The MTD defined by this Phase I trial represents a 67-10046 increase in etoposide and a 25% increase in carboplatin compared to prior studies. Cancer and Leukemia Group B (CALGB) plans to study further dose intensification of this regimen with colony-stimulating factors.

Enhanced tmtitumor effkacy of a combination of CR-N, a new derivativeof wnptothecin, and cisplatinagainst humwhmg tumor xenografts Kudoh S, Takada M, Masuda N, Nakagawa K. Itoh K, Kusunoki Y et al. Depr of Second buemal Medicine, Osaka Preferrural Habikino Hospital, 3-7-l Habikino. Habikino, Osaka 583. Jpn J Cancer Res 1993;84:203-7.

‘The objective of this study was to evaluate the antitumor efficacy of combineduseof?-&yl-10+-(1-piperidino)-1-pipetidino]catbonyloxy-

camptothecin (CPT-11) and cisplatin (CDDP). The antitumor activities of CPT-I 1, CDDP and their combination against 3 human lung tumor xenogratts were estimated using congenitally athymic BALB/c (nu/nu) mice. The doses were 47 mg/kg for CPT- II and 6 mgikg for CDDP on days 1,5 and9. Incombinationtherapy, halfofthesingledosageofeach agent was used. The doses were administered intraperitoneally. The antitumor activity and toxicity were evaluated in terms of the tumor volume and body weight change of mice. respectively. The combination therapy resulted in a statistically significant htmor regression compared totheuseofoaly CPT-I I orCDDPintwotumorxenogtaftsoutofthree. The toxicity of the combination therapy was no higher than that of CPT- I1 or CDDP alone. These results suggest that the antitumor activity of the combination of UT-1 1 and CDDP is superior to that of UT-1 1 or CDDP alone.

Radiotherapy

Severe cormary artery diseusa after radiation therapy of the chest and mediastinum: Cliniul presentation and treatment Orzan F, Brusca A, Conte MR, Presbitero P. Figliomeni MC. Isr. di Med./Chir. Cardiovascolare. Universira’ di Torino, Corso Dogliorri -14. 10126 Torino. Br Heart J 1993:69:496-500.

Objecriw: To detine the clinical and angiographic features and the therapeutic problems in patients with coronary artery di- after therapeutic sirradiation of the chest. Design: An observational retrospective study. Serting: The cardiac catheterisation laboratory, university medical school. Patients: 15 subjects (8 men and 7 women, aged 25-56 years, mean 44) examined in the cardiac catheterisation laboratory. who had significant coronary artery disease years after having radiation treatment to the chest and anterior mediastinum. In the early stages of the study angiography was performed because of typical symptoms of ischaemic heart disease. Later on it was performed because of a high index of suspicion in people with signs of extensive radiation heartdamage. Mainoutcomemeasures: Clinicalandeiectrocardiographic evidence of iscbaemic heart disease; echocardiographic signs of pericardial, myocardial or valvar involvement: angiographic evidence of coronary arterial stenosis, with special attention to the ostia; haemodyaamic and angiographic signs of pericardial, myocardial, and valvar disease. Survival and symptomatic and funftioaal status were ascertained after medical or surgical treatment. Resulrs: The patients were relatively young and had no risk factors. Seven patients had no signs or symptoms of ischaemic heart disease. Ten patients had ostial stenosis, which was associated with extensive involvement of other cardiac structures in nine of them. Seven required surgical treatment for coronary artery disease. Two died, one at surgery and the other one six months later. Fivepatientshadcomplicationssssociatedwithinadiation. Concfwiotw Coronary arterial disease can be reasonably ascribed to the effectsofchestirradiationwheathepatieatsareyoungandfree fromrisk factors, espzcially if the obstructions are ostial and there is important damage to other cardiac strucmres. In patients with damage to other cardiac structures angina and infarction are often absent and coronary angiography szems to be mandatory. Patients often require surgical treatment and postoperative complications are common.

Lung cancer after rudiution therapy for breast amcer Neugut AI, Robinson E. Won Chul Lee Murray T. Kanvoski K, Kutcher GJ. Columbia Uniwrsify, Colkge of Physicians andsurgeons, 630 West 168th Sweet, New York, NY10032. Cancer 1993;71:3054-7.

Background. Radiation, including radiation therapy (RT) for a variety of conditions, is known to be a lung carcinogen. Merhadr. Data from the Surveillance, Epidemiology, and End Results program of the Nauoaal Cancer institute for 1973-1986 were utilized to investigate