228

Cis-Platin~n and Vindesine in Combination in the Treatment of Non-Small Cell Lung Cancer. Carmichael, J., Gregor, A., Cornbleet, M. A. et al. Imperial Cancer Research Fund Medical Oncology Unit, Western General Hospital, Edinburgh, U.K. Eur. J. Cancer Clin. Oncol. 21: 811-814, 1985.

Sixty-three patients with advanced non-small cell carcinoma of the bronchus were treated with a combination of cis- platinum and vindesine. All patients had measurable disease and were of good per- formance status; none had received prior chemotherapy or radiotherapy. Thirty-three per cent of patients responded, with five patients achieving complete remission. Median duration of response was 4 months, with a median survival of 14 months in the responsers, compared with 6.5 months in the whole group and 4.8 months in the non-responders. Severe toxicity was en- countered, with alopecia, gastrointesti- nal toxicity and neurotoxicity common. Myelosuppression and renal toxicity were not dose-limiting. Thus the activity of this drug combination is confirmed, but severe toxicity precludes its widespread use in clinical practice.

Unresectable Non-Small Cell Lung Cancer Chemotherapy with Hi~-Dose Cisplatin and Etoposide. Scagliotti, G.V., Lodico, D., Gozzelino: F. et al. Institute of Internal Diseases, Department of Pulmonary Diseases, S. Lui- gi Gonzaga Hospital, I-i0042 Orbassano, Italy. Oncology 42: 224-228, 1985.

69 patients with unresectable non-small cell lung cancer, previously untreated, received cisplatin 100?mg/m on day 1 and etoposide 120 mg/m- on days 4, 6, 8, at 4-week intervals. 66 patients were evaluable for tumor response and toxicity. Overall objective response was 25.7% (3 complete responses and 14 partial respon- ses). Response rate in limited disease was 41% and in patients with performance score 0 it was 40%. Squamous cell carci- noma and adenocarcinoma responded in 31 and 24% of evaluable patients. Complete response was associated with a long dura- tion of remission. Median survival time of responding patients was significantly superior to the median of nonresponding patients (p < 0.001) but compared to stable disease no statistical significan- ce was demonstrable (p > 0.05). Hemato- logical and renal toxicity of proposed regimen was generally mild. Nausea and vomiting were the most noxious side ef- fects.

Comparison of Vindesine plus Cisplatin or Vindesine plus Mitomycin in the Treat-

ment of Advanced Non-Small Cell Lung Cancer. Shinkai, T., Saijo, N., Tominaga, K. et al. Depart- ment of Internal Medicine, National Cancer Center Hospital, Chuo-ku, Tokyo 104, Japan. Cancer Treat- ment Rep. 69: 945-951, 1985.

Fifty-eight patients with advanced non-small cell lung cancer ~ere randomly allocated to receive vindesine (39mg/m- every week) plus either cispla5 tin (80 mg/m" every 3 weeks) or mitomycin (8 mg/m- weekly x 3, then every 3 weeks). No patients achie- ved complete response. Among the 28 patients treat- ed with vindesine plus cisplatin, there were 12 partial responders (42.9%); among the 30 patients treated with vindesine plus mitomycin, there were only three partial responders (10%) (P < 0.005). Th4 median duration of response was ii.5 weeks (ran- ge, 4-25) in the patients treated with vindesine plus cisplatin. The median survival times for pa- tients treated with vindesine plus cisplatin and vindesine plus mitomycin were i0.I and 10.2 months, respectively; there was no statistical difference in survival time between the two groups. Initial performance status was the strong predictor of pa- tient survival. Toxic effects, including moderate myelosuppression, nephrotoxicity, peripheral neuro- pathy, and gastrointestinal symptoms, were generally manageable. The combination of vindesine and cis- platin appears to be effective against advanced non- small cell lung cancer.

Combination Chemotherapy with Bleomycin, Etoposide, and Cisplatin in Metastatic Non-Small-Cell Lung

Cancer. Osoba, D., Rusthoven, J.J., Turnbull, K.A. et al. " Toronto-Bayview Regional Cancer Centre, Toronto, Ont. M4N 3M5, Canada. J. Clin. Oncol. 3: 1478-1485,

1985. Fifty-three patients with recurrent and advanced

stage (III and IV) non-small-cell lung cancer (NSCLC) were treated with a combination of bleomycin, etoposide (VP-16-213), and cis-diamminedichloro- platinum (BEP). Forty-eight patients were apprai- sable for response. The response rates were 44% for the entire group, 57% in 30 patients with combined squamous-cell and large-cell carcinoma, and 22% in 18 patients with adenocarcinoma (40%, 50%, and 19%, respectively, if patients not appraisable for re- sponse are included as nonresponders). The median survival time of patients with squamous-cell and large-cell carcinoma was slightly longer than that of patients with adenocarcinoma (23 weeks v 19 weeks) Patients with responsive disease survived signifi- cantly longer (median, 34 weeks) than did patients with unresponsive disease (median, 1'6 weeks) ~ = .001). In the entire group, the median survival time of patients with an Eastern Cooperative Onco- logy Group (ECOG) performance status of 0 or 1 was better (23 weeks) than of those with a status of 2 or 3 (15 weeks), but this difference was not seen in the subgroup with squamous-cell and large-cell carcinoma (24 weeks v 23 weeks, respectively). Thus, the performance status was not of prognostic value in the histologic subgroups experiencing the best response rate. There were two treatment-related deaths, but otherwise the toxicity of BEP was