Abstracts/Lung Cancer 12 (1995) 265-329

the response rate of primary treatment was 30.0% (6tzO). In NSCLS group, the rate of primary treatment was 22.9% (S/35), and that of seoondary treatment was 13.3% (4/30). From the result it was found that the rcsponw r&c of primary treatment was higher than that of secondary treatment, and that the main side - effect of CE regimen was mild Icukopenia. and the other side-cffcets included gastrointestinal symptoms, alopecia and mild hcpatic function changes. The influence of CE regimen on immunity was temporary, and till soon recover. Repeating the rcgimcn is reasonable. So we think that CE regimen is one of the best regimens for SCLC patients.

RespoaserateofsmallcellhmgcancertrertodwitbCECAPaJtermIting &m-WY Zheng X, Sun Y, Liu Y. Cancer Hospifal, Chinese Academy ofMedica/Sciences, Beijing 100021. Chin J Oneol 1994,16:302-S.

From Sep. 1989 to Dee. 1992, 122 cvalusblc patients with small eelI lung cancer (SCLC) treated with chemotherapy combined with radiotherapy in our hospital wcrc analyscd. There wcrc 95 men and 27 women. The age ranged from 20 to 70 yews. All were proven by pathology or cytology. They all did not receive previous trcatmcnt and had a measurable mass. Of them 83 patients had limited disease (LD) and 39 extensive disease (ED). Using CE-CAP sltemating chemotherapy, 48 LD and 27 ED wow given two cycles, 35 LD and I2 ED four cyctes. In this series, remission time was not evaluated Laxause all patients rcccived radiotherapy shortly atIer chemotherapy. Of 122 patients, 10 patients (8.2%) achieved CR, 89 (72.9%) PR, 18 (14.7%) S and 5 (4%) F! The total response rate was 81 .I% (99/122), which is higher than that of COMVP and PE-CAV regimens. The rcsponsc rates were 80.0% and 82.9% in hvo and four cycle groups. respectively. There was no significant difference between the two groups. The main toxicity observed was nausea, vomiting and bone mmow suprcssion, but were tolerated by the patients. In wnclusion, CE-CAP regimen can bc rccommcndcd as the treatment of choice in SCLC.

Gene exprerrsion of snmatostatin rPeeptor @types, SSTRl aod SSTR2, in human lung cancer cell lines Fuji& T, Yameji Y, Sate M, Murao K, Takahara J. Firer Depr. oflnfcrmd Medicine, Kagowo Medical School. 1750-I Ikenobe. Miki-rho. Kilo-gun, Kagawa, 761-07. Life Sci I994,55: 1797-806.

SomatostatinfSS) acts as a universal endoelinc off-wioh, and also inhibits the growth of ncumcndocrinc humors thmugh its spezitic receptors. Small eelI lung eenecr (SCLC) dcmonstmtes some neumcndoerine characteristics and has been proposed as a candidate for treatment with SS and its analogucs. In the present study, WC investigated the expression of somatostatin reocptor (SSTR) subtype (SSTRI and SSTR2) mRNA in various human lung caneor cell lines by the scnsitivc rcvcrsetmnseription-PCR method and Southern blotting. The levels of cxprcssion of SSTRI mRNA wcrc higher in both SCLC and squamous cell carcinomathan in adcnocarcinoma cell lines. Intemstingly, SSTRI gcnc expression was independent of that of SSTR2 in each SCLC cell line, although the cxprcssion of both genes showed a positive correlation in non-SCLC eells. Membranes fmm a ecll line exhibiting highest expression of SSTR2 gcnc bound SS and its anelogue, oetreotidc, with moderate affinity. These findings may provide useful information for the future clinieal application of SS and its analogucs for the treatment of lung CBnccT.

Phase I and pharmacologic study of iriaotecaa and etoposide with recombinant humaa granulocyte coloay4mulatingfactor support for advanced long cancer Masuda N. Fukuoka M. Kudoh S. Matsui K. Kusunoki Y. Takada M et al. Deparbmnt of Intern01 Medicine, Osaka Prefechwal Habikino Hcqilal, 3-7-1 Habikino, Hobikitio, Osaka 583. J Clin Oneol 1994,12:1833-41.

Purpose: We conducted a phase I trial of irinotcoan (CPT- 1 I), a topoisomcrssc I inhibitor, combined with etoposidc, a topoisomcm II inhibitor, and recombinant human granuloeyte colony-stimulating factor (rhG- CSF) support because of the overlapping neutrophil toxicity of both drugs. The aim was to determine the maximum-tolcr&d dose of CPT-11 combined with a fixed dose of ctoposide in patients with advanced lung eaneer, as well as the dose-limiting toxicities of this combination. Palienlr and Methods: Twenty- five patients with stage IJl or IV lung CB~CCT, 15 (60%) with prior chemotherapy, were trcatcd at d-week intervals

using CPT-I I (90~minute intravenous infusion on days l,8, and 15) plus etoposidc (80 mp/rnl intravenously on days I to 3). In addition, rhG-CSF (2 igIkg!d) was given from day 4 to day 21, except on the days of CPT-I 1 cdministmtion. The starting dose of CPT-I I was 60 mplm’, and it was escalated in IO-mg/m’ incrcmcnta until the maximum-tolcratcd doxc was reached. Restdrr: The maximum- tolcmtrd dose of CPT-I 1 was 90 mp/m’, since two ofthc three patients developed grade 3 to 4’lcukopenia or grade 3 to 4 diarrhea during the first cycle of treatment of this dose level. Diarrhea and lcukopcnia were the dose-limiting toxicities, while thrombooytopcnia was only a modcmtc problem. Elimination of CPT-I I was biphasic, with a mean l SD 0 half-life of 18.17 f 9.09 hours. The mean terminal half-life of ‘I-ethyl-IO- hydroxycamptothecin (SN-38; the major mct&oliteofCPT-I l)was43.40*37.84 hours. Thenwasoneeomplctcrcspon~ (5%) and eight partial rcsponscs (38%) among 21 ssscssable patients, for an overall response rate of43%. The response rates for small-ecll lung eancef (SCLC) and non-smallcell lung eanecr (NSCLC) were 58% (seven of 12 patients) and 22% (two of nine patients), respectively. Conc/u.&~: The combination of CPT- 1 I and etoposidc with rhG-CSF support seems to bc active against lung CBIICCI, especially SCLC, with .wxptable toxicity. The rcwmmcndcd dose for phase JI stodics in prcviousiy untreated patients is 80 mdm’ of CPT- I I (days I, 8, and 15) and 80 rndrn’ of ctoposidc (days 1 to 3) plus 2 i@kg of rhG-CSF (days 4 to 21, cxeept when CPT-I 1 is given). In addition, 70 mplm’ of CPT-I 1 appcam to bc the appropriate dose for previously treated patients receiving this regimen.

!%mgk-agent activity ofweekly gemcitabine ia advanced q on-small~ell long cancers A pbase II study Anderson H, Lund B, Bach F, Thatcher N, Walling J, Hansen HH. CRCDMO, Christie Hospital Manchesrer: Wilmslow Rda Manchesre,: M20 9BX. J Clin Oncol 1994,12:1821-6.

Purpose: TO evaluate the efficacy and safety of gemcitabine, a pyrimidine antimetabolite with activity against solid tomows. Patienti andMe&&: Eighty- two patients with unresectable stage IIIa to IV non-small-cell lung cancer (NSCLC) were entered. The tirst 54 patients rcccivcd gemcitabine 800 mum’, and subsequent patients 1,000 mgJm’, as a 30-minute intravenous infusion on days 0, 7, and 14. Courses of therapy wac repeated every 28 days. Twenty percent dosage escalation was permitted a&r eou~se no. I if World Health Organization (WHO) toxicity was = I. ResulL~: Sixleen (20%; 95% confidence interval ICI], 12% to 31%) of 79 patients assessable for response had independently validated partial responses, with B median duration of 7 months. The overall median survival duration was 7 months. Gemcitabine improved disease-rclatcd symptoms (70% patients) and increased WHO performance status (44%). Toxicity was generally mild and reversible. Patients experienced little WHO grade 3 and 4 toxicity, with anemia in four (5%), thrombocytopcnia in one (I@%), leukopenia in six (7%), and neutropcnia in 18 (22%). Infection occurred in nine patients (12%) during the study (four were neutropenio), but there were no episodes of WHO grade 3 or 4 infection. WHO grade 3 and 4 biochemical toxicity occurred with transient elevations of transaminascs in IO patients (12%). Two patients had transient WHO grade 3 elevation of strum crcatininc levels. and hvo developed acute renal failure 4 and 6 weeks afier the last dose of gemcitabinc. There was no WHO grade 4 symptomatic toxicity. WHO grade 3 vomiting occurred in 3 I patients (38%) and grade 3 alopecia in one (I%). Flu-like symptoms were associated with 8emcitabinc administration in 36 patients (44%). Twenty-six peticnts (32%) expxicneed fever (1% WHO grade 3). 33 (40%) ankle edema not assoeiatcd with cardiac failure, 31 (38%) lethargy, and I1 (13%) dyspnut. Conclusion: Gcmcitabinc is an active new agent in the treatment of NSCLC. This schedule was associated with little alopecia or myclosupprtssion. Gcmcitabine warrants further investigation in other malignancies and in combination with other agents.

Randomized trial comparingweekly verses s-week dEmOtherapy in small- cell lung cancer: Acancer research campaiga trial Souhami RL, Rudd R, Ruiz de Elvira M-C, James L, Gowcr N, Harper PG. ~epartmenl of oncology. Unix College London Medical School. Middlesex Hospital, London WINBAA. J Clin Oneol 1994;12:1806-13.

Purpose: A randomized trial of chemotherapy, given on either * l-week or c 3-week schedule, was performed in small-cell lung cancer (SCLC) pticnts. The aim was to determine if weekly scheduling produced survival superior to conventional treatment. Patients ondMe&ods. Four hundred thirty-eight patients