52

tases, female sex, no subcutaneous metas-

tases, non-large-cell histology, 5% prior

weight loss, no symptoms of shoulder or arm

pain, and no liver metastases were predict-

ors of longer survival. Of particular inter-

est was the finding that response duration

was significantly longer (P = .002) for

those patients who experienced a longer time

to best response. In addition, patients who

survived > 1 year experienced greater de-

grees of nonlethal toxicity, in particular,

gastrointestinal and hematologic, than

patients who did not survive 1 year, (P =

.006). A detailed chart review of 32 2-year

survivors and 32 matched controls

demonstrated that maintenance or improvement

of performance status and maintenance of

serum albumin levels at 3 months from the

initiation of treatment were both important

predictors of longer survival.

Etoposide and High-Dose Cisplatin in Good-

Risk Patients with Advanced Squamous Cell

Carcinoma and Adenocarcinoma of the Lung.

Ardizzoni, A., Canobbio, L., Pronzato, P. et

al. Divisione di Oncologia Medica, Istituto

Nazionale per la Ricerca sul Cancro, 1-16132

Genova, Italy. Cancer Treat. Rep. 70: 891-

892, 1986.

Fifty patients with advanced squamous

cell carcinoma and adenocarcinoma of the

lung having good prognostic features

(performance status < or = 2; weight loss <

or = 10%; and age < or = 70 years; absence

of brain metastases; and no prior treatment)

were treated on an outpatient basis with

etoposide (120 mg/m 2 on days i, 3, and 5)

and cisplatin (60 mg/m 2 on days 1 and 2)

every 21-28 days. One complete response and

14 partial responses were observed, with a

median duration of response of 170 days and

an overall median survival of 230 days.

Toxicity was generally mild. Despite the

high-dose cisplatin employed and the choice

of patients with favorable prognostic fac-

tors in this study, results of this therapy

remain disappointing.

Etoposide (VP-16) and Cisplatin in Pre-

viously Treated Small-Cell Lung Cancer;

Clinical Trial and In Vitro Correlates.

Batist, G., Carney, D.N., Cowan, K.H. et al.

NCI-Navy Medical Oncology Branch, Bethesda

Naval Hospital, Bethesda, MD 20814, U.S.A.

J. Clin. Oncol. 4: 982-986, 1986.

Treatment of patients with relapsed

small-cell lung cancer (SCLC) has been

uniformly unsuccessful. Recently, the com-

bination of etoposide (VP-16) and cisplatin

in this setting has been reported to result

in up to 50% response rates. We treated 29

patients with relapsed SCLC with this com-

bination and found only a 12% response rate.

The discrepancy between our results and

those of others is most likely due to dif-

ferences in prior treatment of the patients,

although the effect of dose and schedule

modifications are considered. Our patients

had received a six-drug regimen over a

median of 7 months and had a median drug-

free interval before this treatment of only

three weeks. Evidence is presented that sug-

gests that this aggressive initial therapy

affected both host tolerance to further

treatment and the development of tumor

resistance at the cellular level.

Random Prospective Study of Vindesine Versus

Vindesine Plus High-Dose Cisplatin versus

Vindesine Plus Cisplatin Plus Mitomycin C in

Advanced Non-Small-Ceil Lung Cancer.

Einhorn, L.H., Loehrer, P.J., Williams, S.D.

et al. Department of Medicine, Division of

Hematology-Oncology, Indiana University

School of Medicine, Indianapolis, IN, U.S.A.

J. Clin. Oncol. 4: 1037-1043, 1986.

In this phase III randomized study, 124

evaluatable patients with unresectable non-

small-cell lung cancer (NSCLC) were ran-

domized to vindesine v cisplatin (120 mg/m 2)

plus vindesine v cisplatin (60 mg/m 2) plus

vindesine plus mitomycin C. The objective

response rate for cisplatin and vindesine

was 27% v 20% for cisplatin, vindesine, and

mitomycin C, and 14% for vindesine alone (P

= .25 for cisplatin and vindesine v

vindesine). The percentage of patients

having stable disease (no progression for a

minimum of 3 months) was 20% (cisplatin and

vindesine), 27% (cisplatin, vindesine, and

mitomycin C), and 26% (vindesine alone),

respectively. The median survival time for

vindesine was 18 weeks, compared with 26

weeks for cisplatin and vindesine and 17

weeks for cisplatin, vindesine, and

mitomycin C. Overall survival was not

statistically different for cisplatin plus

vindesine v vindesine (P = .65). There was

no evidence for improved duration of remis-

sion or survival of responders with the

cisplatin (120 mg/m 2) and vindesine arm.

This study failed to demonstrate sufficient

therapeutic benefit for cisplatin and vin-

desine (+ or - mitomycin C) compared with