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Phase II clinical and pharmacological study of oral 4- demethoxydaunorubicininadvancednon-pretreatedsmallcelllung cancer. Milroy R. Cummings J. Kaye S.B. Banham S.W. Deparfmenf of Respiratory Medicine, Glasgow Royal Infirmary, Glasgow G32 2ES. Cancer Chemother Pharmacol 1987;20:75-77.

4-Demethoxydaunorubicin (4-DMDNR) is an oral anthracycline with antitumour activity demonstrated in a number of clinical studies. We have assessed the usefulness of 4-DMDNR in 16 patients with advanced small cell lung cancer, none of whom had received previous chemotherapy. There were no complete or partial responders among the 14 evaluable patients, but 9 patients showed a minor radiographic improvement and 6 reported transient symptomatic improvement. Side effects were mostly minor or moderate, although one patient succumbed to septicaemia during neutropenia following treatment. There was no evidence ofcardiotoxicity in any patient. Pharmacological studies were undertaken in 8 patients. A previously undescribed metabolite, identi- fied as the 7-deoxyaglycone of 4-demethoxydaunorubicinol, was de- tected in 3 patients and these 3 patients all showed some anti-tumor response.

Mitomycin C, vinblastine and cis-platin. An active regimen for advanced non-small cell lung cancer. Giaccone G, Bagatella M, Donadio M et al. Division of Medical Oncology, Ospedale S. Giovanni, Torino. Br J Cancer 1987;56:47.5-8.

Fifty-one patients with advanced non-small cell lung carcinoma were treated with a combination of mitomycin C, vinblastine and cis-platin (MVP). Most cycles were given on an out-patient basis. Major side effects were leukopenia and peripheral neurotdxicity: one patient died ofsepsiswhileleukopenic. In44evaluablepatientstheresponseratewas 50%, with onecompleteresponse. Overallmedian survival time was280 days and median duration of responses was 232 days. A better perform- ance status, disease limited to one hemithorax and no prior exposure to chemotherapy positively influenced the survival. MVP is an effective chemotherapy for non-small cell lung cancer and further experience with this combination is warranted.

High dose chemotherapy with autologous bone marrow transplan- tation in the treatment of small cell lung cancer. Pica JL, Baume D, Ostronoff M et al. Institut Gustave-Roussy, 94805 VillejutfCedex. Bull Cancer 1987;74:587-95.

Nineteen patients were treated with high dose chemotherapy fol- lowed by an autologous bone marrow transplantation. The chemother- apy regimen was an association of BCNU, procarbazine, etoposide, melphalan. Six patients had a progressive disease; 4 short-term com- plete remissions were observed. In 13 responding patients, 6 maintained complete remissions were noted.

Therapeutic results in the treatment of small cell carcinoma: EORTC Lung Cancer Working Party (Belgium) experience. Scuher J.P. Service de Medecine et Labormoire dlnvestigation, Clin- ique HJ. Tagon, Institute Jules-Bordet, Centre des Tumeurs de l’llniversite Libre de Bruxelles, 1000 Bruxelles. Bull Cancer 1987:74:565-8.

The EORTC Lung Working Party is a regional cooperative group that has investigated various chemotherapeutic regimens in patients with small cell lung cancer. Results of the CAV, AVE and CAVE studies are summarized as well as the pilot study of late intensification in this type of patients.

Chemotherapy in small cell lung cancer. Ruffie P, Le Chevalier T. Comite de Pathologic Thorucique. Institut Gustave-Roussy, 94805 VillejuifCedex. Bull Cancer 1987;74:531-40.

A 60% complete remission rate in localized stage and 30% rate in metastatic stage are obtained with chemotherapy in small cell lung carcinoma. Chemotherapy can be combined with radiotherapy. Some alternating, high dose and maintenance regimens are discussed.

Radiotherapy

Radiosensitivity related to neuroendocrine and endodermal dfier- entiation in lung carcinoma lines. Duchesne G, Cassoni A, Pera M. Institute of Cancer Research, Sutton, Surrey SM2 SPX. Radiother Oncol 1988;13:153-61.

A panel of human lung carcinoma lines was studied with respect to hormone production and intermediate filament expression to distin- guish between endodermal and neuroendocrine differentiation. An index of the degree of neuroendocrine differentiation of each line was derived from the presence or absence of hormone production, cytoker- atins, neurohlaments and an embryonic endodermal cell marker, which allowed identification of three groups showing high, intermediateor low neuroendocrine expression. This grouping correlated well with the in vitro radiosensitivity of the lines, those expressing pure neuroendocrine features being significantly more radiosensitive than those with an endodermal phenotype with the intermediate group having interrnedi- ate sensitivity. Use of such an index might predict those patients likely to benefit from the use of radiotherapy in their management,

Radiotherapy as an alternative to surgery in elderly patients with resectable lung cancer. NoordijkEMVd,PoestClementE,HermansJ, WeverAMJ,LeerJWH. Department of Clinical Oncology, University Hospital, 2300 RC Lei- den. Radiother Oncol 1988;13:83-9.

From 1978 to 1983.50 patients with a peripherally located non-small cell tumor of the lung were irradiated with curative intent. These patients were not operated upon because of poor cardiac or pulmonary condition, old age or refusal to operate. Mean age was 74 years, 40 patients being over 70 years of age. All patients had T,, N&, tumors according to the AJC classification and received 60 Gy to the primary tumor only. The overall response rate was 90%. with 50% complete responses in tumors smaller than 4 cm. The crude overall survival rates were 56% at 2 years and 16% at 5 years, with a median survival of 27 months. Age did not influence survival. There was a strong correlation of survival to tumor size, with 5year survival rates of 38, 22, 5 and 0% in tumors with diameters of -2, 2-3, 34 and ti cm respectively. Only 5 out of 20 complete responders had a local recurrence, the 5-year survival in this group was 42%. These results compared favorably to a group of 86 patients over 70 years ofage who were selected foroperation in the same hospital. The 2- and 5-year survival rates in these patients were 48 and 26% respectively, median survival being 23 months. We conclude that in patients over 70 years of age with resectable lung cancer, radiotherapy with curative intent should be offered as an alternative to operation, especially if the tumor is not larger than 4 cm. The wait-and-see policy in inoperable patients of this age group must be abandoned.