Abstracts/Lung Cancer 10 ( 1993) 266-286

vomiting,dia~ea,obshpat~on(moslly WHOgr&sI+II), buttreatment was not required. Toxic effects on organs or late toxicity could not be documented. Co~llusions:Thebighpmportiwofpetientswithstationary tumor states was remarkable. Objective tumor remission was extremely rare. On the other hand, the rate of progression was low. This might be

explained by the fact that EF IS rathera phenotype modifier than a typical

cytostat,c drug.

The combination of mitomycin, vinblastine and cisplatin is active in the palliation of stage IIIB-IV non-small-cell lung cancer Vmante 0, Bari M, Segati R, Auarello G, Sampognaro E, Rosetti F.

Cenrro Oncologico Mulrizonale, ULSS 17, I-36033 Noale. Oncology (Switzerland) 1993:50:14

Twenty-eight patients with stage IIIB-IV non-small-xll lung cancer were treated with mitomycin C. vmblastine and ctsplatin (MVP) in a phase II - minimax 2-stege design randomized trial (with cisplatin plus etoposide as control arm). As indicated by tbe study design. the accrual wass(oppedafterthellthrsponder,andtheco~bination~~~n~de~ as active at the 40% level. Forty-six percent of patients had an

onprovement of then initud Kamofsky performance score, lasting a

median of 24 weeks, and about 38 ‘% had acomplete relief of symptoms.

Hematologlc toxicity was moderate to severe in about 50% of patients,

andneurologic toxicity mnbout 18%; nograde toxicitywasobserwd.

The esttmated median progression-free survival was of 25 weeks. The

observedactivityandmartageability. togetherwith thepositiveeffect on

patient quality of life, account for a positive. evaluation of MVP as a palliative treatment in advanced non-small-cell lung cancer.

Comparisonofcisplatinplwsindesinewithcisplatinplusmitcmycin C for treatment of advanced non-small-cell lung cancer SLmizu E. Ogun T, Sooe S, Nakayama T, Doi H, Takishita Y. 3rd Depanment of Internal Medicine, Tokushima Univ School of Medicine, Kurumoto-cho, Tokwhimn 770. Oncology (Switzerland) 1993;50:5-9.

Seventy-six patients with advanced non-small-cell lung cancer were randomly allocated to hvo groups nod treated with cisplatin (CDDP; gOmg/m* on day 1) plus either vindesine (VDS; 3mg/m’on days 1 and

8) or mitomycin C (MMC; Smglm’on days I and 8) every 34 weeks. Theobjectiveresponserateswere2646 (10/38) forCDDPplusVDS and 32 96 (1 I /34) for CDDP plus MMC; the corresponding response rates

in patients with adenocarcmoma were 7% (l/14) and 43% (6/14),

respectively. The median survival times of patients treated with CDDP

plus VDS and CDDP plus MMC were 33 and 30 weeks, respectively,

the difference in survival times in the hvo groups oat beiig significant.

There was no significant difference in toxic effects in the two groups

except that alopecia and leukopema were more frequent III pattents treated wth CDDP plus VDS.

Plptin-rindgin-~e(yein-bleomyein regimen in stage Iv non small cellllmg- Souquet PJ, Foumel P, Jorda M, Lneonec E, Piperoo D, Trillet V eta]. ARISTOT, Facuk de M.&e&e de Lyn, 8 Avenue Rockefeller. 69008 Lyon. Bull Cancer 1993;80:80-2.

From July 1987 to July 1988, 35 patients with non small cell lung cancer, stage IV, were included in a phase II trial (CLOT NPC 87101).

The treatment was as follows: cisplatitt 50 mg/d day 1, vindesin 3 mg/ & day 1, mitomycin 6 mglm’day 2, and bleomycin I5 mg/day, day I

+ 2 by continuous infusion. The evaluation for response was assessed

afterthreecoursesofche.motberapy. Tberesultswerepoor: anobjective

response was observed in three. patients: three partial responses end no

complete response. Beaux of hmmr progression (16 patients) or toxicity (three patients). 21 patients did not complete the three cycles of chemotherapy. The median survival rate was 100 days. Toxicity was mild: grade 111 neutropenin occurred in one patient, grade IV

thrombocytopenia was also observed in one patient. We conclude that this treatment has only P poor efficacy in stage IV non small cell lung

cancer.

A phase II study of ifosfamide in combination with etoposide and cisplatin in the treatment of e&n&e small cell lung cancer Evans WK, Stewart D, Logan D, Maroon J, Goss G, Shepherd FA et

al. Orrawa Regional Cancer Cenrre, 190 Melrose Ave. Otrawa, Onr.

KIY4K7. Semin. Oncol. 1992;19:Suppl. 12:51-7. The combmation of etoposide and cisplatin has become one of the

standard treatments for small cell lung cancer. Ifosfamide. an analogue of cyclophosphamide, has demonstrated single-agent antitumor actwlty comparable wth that of the most active agents used to treat small cell

lung cancer. Because ifosfamide 1s relatively nonmyelosuppreswe and

Its principal dose- lrmiting toxicity, urotoxictty, has largely been ehmmated wth the introduction of the uroprotective agent mesna, we

undertook a phase II study of the combination of all three agmts

(etoposideiifosfamideicisplatin) ingood-performance-status, extensive-

dwxsr patnents 70 years of age or younger. Twenty-five patients (17

man and eight women; median age, 58 years) were treated wth 75 mg/ mletoposide, 20mg/m1cisplatin, and I .Og/ml/difosfamideadministered mtravenously for 5 days. Mesna (200 mglm’) was given as a bolos prror to the first day of chemotherapy and then daily by contmuous infusion (900 mg/mz over 24 hours) between admmrstrataons of chemotherapy.

Mesna was continued for 12 hours after the last dose of Ifosfamide. Treatment cycles were planned every 4 weeks for four cycles. Due to

severe toxlcitles m the first eight patients, subsequent patlents recewed only 4 days of treatment (20% dose reduction). Of the 25 extensive-

disuse patients studwd, 23 are evaluable for response. Seven (30%)

achieved a complete response and 10 (43%) had a partud response

(ovsrall response rate. 73 W). Five patbents (22%) had stable dlstxw

(< 50% decrease and no evidence of disease progression for at least 4 weeks), and disease progressed in 1 patient (4%). The median survival tune was 42 weeks (range, 2 to 160+ weeks). Gramdocytopenia was dose-lirmting: median gramdocyte count was 0.486 x lb/L, 21% ot cycles had a granulwyte nadu below 0.2 x lb/L, and four patwts dwd of sepsis. Three patients required platelet transfusion and nine needed

blood transfusion. Microscopic hematuria occurred m eught pabents

(I 1% of treatment cycles) but was reverstble in all cases. A number of

central nervous system symptoms were reported but could not be

definitely attributed to ifosfamide/mesnn. GPstrointestmal toxicity was generally mild, which isattributed to theuseofan aggressiveantiemetlc program. Tbe etoposide/ifoshmide/cisplPtin regtmen is active and produced a complete response rate of 30% in extensive small cell lung cancer; the duration of response and surv~vrd appears similar to that of other standard regimens. Tbe 5day schedule produced excessive

toxicity in this patient population, necessitating P 20% dose reduction

(by using B 4day schedule). The method of administration required a

minimum of 5 hospital days per cycle. The regimen should be modified

for outpatient useand for further study ma randomizedcomparison wth

etoposide/cisplatm.

Phase II study of cisplatin, ifosfamide, and etoposide combination for advanced non-small cell lung cancer: Final report ShoinianM, LeeJS, DhingraHH,Greenberg J, Hong WK. Depanmenr of Medical Oncology, M.D. Anderson Cancer Cemer, Box 80. 1515 Holcombe Blvd, Houston. 7X 77030. Semin Oncol 1992;19:Suppl.

12:58-64.

Ifosfamide has shown promismg single-agent activity m non-small

cell lung cancer. We combined tfosfamide (1,800 mg/mz, plus 1,100 mgiml of mesna by mtravenous contmuous infusion daily for 3 days)

with cisplatin (20 mgim’ intravenously for 3 days) and etoposide (80 mg/d intravenously for 3 days) and treated 41 patients with recurrent or metastattc non-small cell lung cancer who had received no pnor systemic chemotherapy. Fit&n (40.5%) of the 37 w&able patients had ObJectwe responses (one complete and 14 palal). Patients wth a good Zubrod perfomunce status (ie, 0 or 1) had i( higher response rate

than those with poor performance stahw (le, 2) (I I of 21 [52.4%] v 4 of I6 [25.0%]), but thedifference wasnot statistically slgmticant (P =

.09). Median survival was 28 weeks for all patients and 59 + weeks for

responders, with I1 patients still alive after a median follow-up of 59

weeks (range, 51 to 77 weeks). Overall, treatment was well tolerated,

withgramdwytopeniabeing the most frequent toxicity. Considering the pooled response rate of 32 W with a cisplatmietopostde regimen and the prewous experience from our institution. the results with this three-drug regimen are encouragmg, and its further mvestigation LS warranted, partudarly for patients who have good performance status and m a ntwadjuvant setting.