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all median survival was not improved (36 weeks for the high-dose group vs 43 weeks for the standard-dose group); however, the median survival in patients achieving CR was prolonged (92 weeks for the high- dose group vs 50 weeks for the standard- dose group). These effects were most pro- nounced in patients with extensive disea- se; a CR after induction was achieved in five of nine patients treated with high doses but not in any of those treated with standard doses (P < 0.05). A small group of patients appear to benefit by achieving a long-term remission with intensive in- duction chemotherapy, but this effect may be offset by increased morbidity.

VP-16 and Cisplatin as First-Line Therapy for Small-Cell Lung Cancer. Evans, W.K., Shepherd, F.A., Feld, R. et al. Ontario Cancer Foundation, Ottawa Cli- nic, c/o Civic Division, Ottawa, Ont. ,KIY 4K7, Canada. J. Clin. Oncol. 3: 1471- 1477, 1985.

Thirty-one patients with small-cell lung cancer (SCLC) were treated with VP 16 and cisplatin as first-line therapy. In the majority of the cases an Adria- mycin (Adria laboratories, Columbus, Ohio) containing regimen was contraindicated becuase of severe cardiac or hepatic disease. Eight patients who presented with cerebral metastases were also included in the series. Eleven patients had limited disease (LD), and 20 had extensive disease (ED). Of the 28 evaluable patients, 12 (43%) achieved a complete response (CR) and 12 (43%) had a partial response (PR). Four patients (14%) either had no respon- se or progressed on treatment. The median duration of response for patients with LD was 39 weeks and for those with ED, 26 weeks. The median survival time (MST) for the whole group of responding (CR and PR) LD patients was 70 weeks (range, 28 to 181+ weeks), and for the responding ED patients, it was 43 weeks (range, 17 to 68 weeks). Gastrointestinal toxicity was mild, but leukopenia and thrombocy- topenia were common. There were four fe- brile episodes during periods of drug- induced neutropenia and this led to one treatment-rel~ted death. Nephrotoxicity occurred in 15 patients and required dis- continuation of cisplatin in two. These results compare favorably with reports of standard induction chemotherapy regi- mens and provide further evidence of the activity of the VP-16 and cisplatin re- gimen in patients with SCLC.

Cisplatin and Etoposide Combination Che- motherapy for Refractory Small Cell Car- cinoma of the Lung.

Porter, L.L. III, Johnson, D.H., Hains-

worth, J.D. et al. Division of Oncology, Department

of Medicine, Vanderbilt University, Nashville, TN 37232, U.S.A. Cancer Treat. Rep. 69: 479-481, 1985.

Twenty-nine patients with refractory recurrent small cell carcino a of the lung were treate@ with cisplatin (40 mg/m ~) and etoposide (200 mg/m-) each day for 3 days, repeated every 3-4 weeks. Fifteen of these patients had received etoposide in their original treatment regimen. Fifteen (52%) of all patients had a major response, as did nine (60%) of the patients with prior exposure to etoposide. Mye- lotoxicity was moderately severe. The median dura- tion of responses was 3 months (range, 6-36 weeks). This study suggests synergism between cisplatin and etoposide. The toxicity seen in this heavily pretreated group of patients suggests that smaller doses be studied in this group. The synergism may be best utilized in the initial regimens against small cell lung cancer.

Combination Chemotherapy with Adriamycin, Etoposide, and Cyclophosphamide for Small Cell Carcinoma of the Lung. A Study by the EORTC Lung Cancer Working Party (Belgium). Klastersky, J., Sculier, J.P., Dumont, J.P. et al. Department of Medicine, Institut Jules Bordet, i000 Brussels , Belgium. Cancer 56: 71-75, 1985.

The current study reports the results of Adria- mycin (doxorubicin), etoposide, and cyclophospha- mide (AVE) in small cell bronchogenic carcinoma. The overall rate of response was 82% in patients with limited disease and 66% in patients with ex- tensive disease; complete remissions have been a- chieved in 20% of the patients with limited disease and in 7% of those with extensive disease. The me- dian duration of survival was 14 months in patients with limited disease and 8.3 months in those with extensive disease. The results, and the analysis of literature, suggest that survival rather than re- sponse should be used to compare studies of chemo- therapy in small cell bronchogenic carcinoma.

Treatment of Non-Small Cell Bronchogenic Carcinoma with Vinblastine and Mitomycin: A Southwest Oncology Group Study. Weick, J.K., Rainey, J.M., Livingston, R.B. et al. Southwest Oncology Group (SWOG-8260), Operations Office, San Antonio, TX 78229, U.S.A. Cancer Treat- Rep° 69: 583-585, 1985.

Forty-five patients with stage III M-I non-small cell bronchogeni~ carcinoma were treated with vin- blastine (i mg/m by iv bolus twice a @ay on 2 con- secutive days) plus mitomycin (i0 mg/m- on day i). This treatment was repeated at 3-week intervals for three courses. Consolidation therapy ~ith doxo- rubicin and cisplatin at doses of 50 mg/m- each was administered to responders every 4 weeks for two courses, with subsequent vinblastine and mitomycin maintenance therapy every 6 weeks. Eleven partial remissions (24%) were achieved, with a median dura- tion of remission of 16 weeks (range, 8-32) and a median survival of 19 weeks. No differences were seen in median duration or remission or survival by cell type or performance status.