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Phase 11 trial of high-dose 24-hour continuous intravenow 5 fluomunwil for advanced non-small cell lung cancer: A cancer and leukemia group B study Citron ML, Modeas C, Propert K, Goutsou M, Green MR. Section of Medical Oncology. Long Island Jnvish Medical Center, New Hyde Park, NY 11042. Cancer Invest 1992;10:215-9.

Eighty-six eligible patients with noo-small cell lung cancer were treated on a Phase II, CALGB stody with high-dose, 24-h continuous intravenous 5-fluorouracil every 2 weeks. Objective responses were seen in 7 (8 96) patientswith 1 (I %) complete response and 6 (7 %) partial responses. The median survival for these patients without prior chemotherapywas 3.8 months. Gastrointestinal attdhematologic toxicity were acceptable for most patients. However, two patients experienced acute clinical deterioration characterized by worsening central nervous system and hemodynamic function beginning near the completion of chemotherapy treatment and resulting in death. Because of its potential for severe, unpredictable neurologic and cardiac toxicity, we do not recommend this dose and schedule of 5-FU for future trials.

Chronic oral etoposide in non-small cell lung carcinoma Estape J, Palombo H, Sanchez-Lloret J, Agusti C, Grau JJ, Daniels M et al. Medical Oncology Department, Clinic Hospital, 170 Villarroel, 08036 Barcelona. Eur J Cancer Part A Gee Top 1992;28:835-7.

25 consecutive inoperable or extended non-small cell lung cancer (NSCLC) patients (19 non-chemotherapy pretreated, 6 non-heavily pretreated) were given oral etoposide, 50 mg/mz/day for 21 successive days, every 4 weeks. 5 partial responses (PR), 9 disease stabilisations were achieved; the overall response rate of 20% (95% confidence interval, 4% to 36%) or 26% in non-pretreated patients. Median survival andPRdurationprobabilitieswere6.7 monthsand6.3 months, respectively. Alopecia excepted (96 % ofpatients), non-haematological toxicity was mild. Haematologicsl toxicity WHO grade II + III mainly consisted of leukopenia (28%).

Calculation of received dose intensity for combinations of drugs using small-cell lung carcinoma treatment regimens as examples Wampler GL, Fryer JG. Box 230, MCVStation, Richmond, VA 23298. Cancer Chemother Pharmacol 1992:30: 199-206.

Programs are presented for the calculation of received dose intensity in combination chemotherapy regimens. These provide methods for determimng the final dose intensity, the mean cumulativedose intensity togetherwith its standardernx, andothertabularaodgmphic summaries. Two ways of dividing patients into high and low received-dose-intenstty groups are proposed. Methods are illustrated using data from Mid- Atlantic Oncology Program (MAOP) 2183, a phase III evaluation of a six-drug alternating combination vsa three-drug ‘standard’combmation treatment for extensive small-ceil lung cancer. Comparisons of received dose intensity with demographic and outcome variables are presented.

Influence of chemotherapy on super&de anion production by polymorphonuclear leukocytes and monocytes in patients with lung cancer Ham N, Ichinose Y, Kawasaki M, Asoh H, Yano T, Maeda K et al. Department of Chest Surgery, National Kyushu Cancer Center, I -I, 3- chome, Minami-ku. Fukuoka 815. Cancer J 1992;5:162-4.

Superoxide anion (0,) production by polymorphonuclear leukocytes (PMN) and monocytes (MN) in peripheral blood was evaluated in 13 lung cancer patients receiving chemotherapy. Chemotherapy decreased 0, production by PMN as well as MN. The amount of 0, production by these cells changed in parallel with cell counts. The lowest level occurred at 2 weeks and recovered to the control level at 4 weeks after chemotherapy. These results indicate that decreased 0, production hy PMN and MN should be considered in addition to decreased counts when assessing defense mechanisms and susceptibility to infection of patients receiving chemotherapy.

Increased myelosuppression during cytostatic treatment and pleural effusion in patients with small cell lung cancer Herrstedt J, Clementsen P, Hansen OP. Department of Oncology, He&v Hospital, Universiry of Copenhagen. DK-2730 Herlev. Eur J Cancer Part A Gen Top 1992;28: 1070-3.

30 patients with small cell lung cancer (SCLC) and malignant pleural effusion were compared with 30 matched patients with SCLC but without pleural effusion. In the 30 with pleural effusion, white blood cell and platelet counts fell significantly after initial chemotherapy, necessitating dose reduction. Of the patients with pleural effusion, 16 developed severe (WHO grade IV) leukopenia, 7 had severe thrombocytopenia, and 2 patients died of infection. Accordingly, exhaustive aspiration of radiologically verified pleural effusion before starting chemotherapy m patients with SCLC is recommended.

reniposide as single drug therapy for elderly patients affected by small cell lung cancer Tu~narello D, Isidori P, Pasini F, Cetto G, Cell&no R. Oncologin Medica, Universita di Ancona, Ospedale Torrette, 60020 Ancona. our J Cancer Part A Gen Top 1992;28:1081-4.

From January 1987 to December 1990, 26/105 previously untreated patients affected by small cell lung cancer (SCLC), not suitable for intensive SCLC treatment since 19 ofthem were older than 70 years and 7 suffered from severe chronic diseases, received induction therapy consisting of teniposide alone, 60 mg/mz on days 1-5, every 3 weeks until disease progression. After a minimum of hvo courses, 24 patients were evaluable for response: 13 with limited disease (ED) and 11 with extensive disease (ED) (2 patients were onevaluable: 1 early death and 1 protocol violation). Response rate, by disease stage, was: in the 13 LD, 1 complete response (CR), 8 partial responses (PR), 2 minor responses and 2 failures; in the 11 ED, 1 CR, 4 PR and 6 failures. The OWX~I response rate was 58% (14124) (95% confidence limits = 38- 78%), comprising 8% CR and 50% PR. Median duration of response was 7 months (range 2-32). Median overall duration of survival was 9 months (range 1.5-36 +). Toxicity was haematological WHO grade III in 13 56 of courses delivered, whereas no further important side-effects were recorded, excludmg alopeaa, which was common. Teniposide usal alone appeared a safe and effective palliative treatment for poor- risk patients; the mqor limitation WBS the low CR rate.