Abstracts/Lung Cancer 13 (1995) 185-232 223

tolerated. In multivariate analysis, the significant parameters were CEA, performance status and response. In conclusion, 72-hour continuous infusion of CDDP and 5-FU for treatment of NSCLC provides similar response and toxicity as previously reported regimens using CDDP.

Recent progress in chemotherapy for advanced lung cancer Negoro S, Fukuoka M. Department of Pulmonary Medrcine, Osaka City General Hospital, 2-13-22, Miyakojimahondori. Miyakojima-ku, Osaka 534. Ipn J Cancer Chemother. 1995;22:451-60.

Recent progress in chemotherapy for advanced non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) may be summarized as follows. 1) In Seven randomized trials of combination chemotherapy compared with best supportive care in stage IV NSCLC, metaanalysis ofindicated that combinationchemotherapy modestly improves survival of patients with advanced NSCLC. 2) Cisplatin-based combination chemotherapy followed by chest irradiation improves outcomes of patients with stage III unresectable NSCLC as compared with radiation therapy alone. 3) Me&analysis has shown that survival is prolonged when radiotherapy is used in combination with chemotherapy in the treatment of limited-stage SCLC. 4) Randomized trials evaluating alternating chemotherapy could not demonstrate the survival benefit in the treatment of extensive-stage (ES) SCLC. 5) The approach to increasing dose intensity has been attempted in the treatment of ES- SCLC. The most common approach is weekly chemotherapy. Results of pilot studies have suggested that this approach prolongs survival of patients with ES-SCLC. 6) Recently several new drugs active against NSCLC and SCLC, including CPT-1 I, taxol, axotere, vinorelbine and gemcitabine, have been developed. In conclusion despite these advances of treatment, the cure rate remains quite low in lung cancer. Further investigations are needed to improve the treatment results for patients with this disease.

Etoposide (VP-16) and carhoplatin as a first-line therapy in the small cell lung cancer (SCLC) Cassano A, Pozzo C, Corsi DC, Noviello MR, Fontana T. Astone A et al. Ist. di Medicina Intemn/Geriotria. Universita Cattolico del Sacro Cuore, Roma. Acta Med Rom 1994;32:453-8.

Chemotherapy is crucial for the optimal management of the SCLC. Many trials have been performed to evaluate the effectiveness of combination therapy or single agent. Several reports showed the superiority of the etoposide-wntaining regimens. The two-drug regimen of cisplatin and etoposide was associated with an increase in median survival and overall response when compared with other treatment programs. From 1992 we have treated 42 patients with histologically confirmed SCLC with etoposide and carboplatin, a cisplatin analogue which is less emetogenic and appears to be without sigticant nefro- or neurotoxicity. The aim of the present study was to evaluate the activity and toxicity of this therapeutic regimen. Eighteen patients (48%) achieved an objective response; the median survival time was 35 weeks. Mielosuppression was the main toxicity with WHO grade 2-3 leukopenia. These results are in agreement with those of other authors who have adopted more aggressive chemotherapies. The identification of new agents active against SCLC and understanding of the basic biology of this neoplasm remains a high priority for clinical investigators and will lead to better treatment options.

Fatd pulmonary toxicity following oral etoposide therapy Dajczman E, Srolovitz H, Kreisman H, Frank H. Deparhnenr of

Medicine. Division Pulmonar Disease, Sir Mortimer B DovisJewish Hospital, 375s Cote St Catherine Road. Montreal, Que. H3T IE2. Lung Cana?r (Ireland) 1995;12:81-6.

oral etoposide has considerable activity in small cell lung cancer

and the low risk of toxicity has resulted in the frequent prescription of this agent in elderly or infirmed patients. We describe a case of fatal pulmonary toxicity following the administration of oral etoposide. This is the first report of biopsy-proven pulmonary toxicity associated with this agent.

Phase II study of prolonged oral etoposide in combination with intravenous cisplatin in advanced non-small cell lung cancer Miller AA, Niell HB, Griflin Jp. VA A@rsMedical Centez Deportment ofMedicine. Division Hematology/Uedical Oncology, 3 North Dunlap, Memphis, TN 38163. Lung Cancer (Ireland) 1995;12:59-65.

The objectives of the study were to evaluate the combination of cisplatin and prolonged oral etopeside for response rate, survival, and toxicity. The treatment regimen consisted of etoposide (50 mg/m*/day) p.o. for 21 consecutive days and cisplatin (100 mp/m’) i.v. on day I every 28 days for up to six courses. Patients with Stage IIlB or IV non- small cell lung cancer who had not received prior chemotherapy and had an ECOG performance status ofO-2 were eligible ifthey had normal bone marrow, liver and renal functions. Patients were followed weekly for toxicity including complete blood counts. The total number ofpatients entered in the study was 60, of whom 56 were male and four female, 40 white and 20 African Americans. Median age was 64 years (range, 39- 77). Performance status 0, I, and 2 was present in five, 39, and 16 patients, respectiveiy. Fourteen patients had Stage IIB and 46 Stage IV disease. A total of 142 treatment courses were administered (median 2, range l-6). Three patients had a complete response and 19 patients had a partial response for an objective response rate of 37% (95% confidence interval, 31-43%). Median survival was 5 months (range, l-39+). Ncutropenia was the major toxicity with Grade 4 occurring in 25 patients after the first course. The following percent of patients experienced severe or Me-threatening hematologic toxicity (Grade 3 and 4 combined) over all courses: leukopenia, 73%; neutropenia, 73%; anemia, 42%; and thrombocytopenia, 37%. Three patients died of neutropenic sepsis. This regimen of prolonged etoposide with cisplatin is active in advanced non-small cell lung cancer, but has substantial toxicity.

Changes of surface antigens in drug-resistant human lung cancer cell lines and their susceptibility to LAK cells Takahashi K, Kondo K, Saito S, Kamamura Y, Ichimori T, Hino N et al. Second Department of Surgery, School of Medicine, University of Tokushima, Tokushima. Jpn J Lung Cancer 1995;35:35-41.

The change of surface antigens in human lung cancer cell lines resistant to cisplatin (CDDP) or etoposide (VP-16) and their suscepti- bilities to human Interleukin-2 (L-2) activated killer cells (LAK) were examined. Cell lines resistant to CDDP (CD-5) and VP-16 (vP-4) were both established from a human small cell lung cancer cell line (N417). The adhesion molecules of CD54 and CD58 in both CD-S and VP-4 were expressed more than in N417. N417 was resistant to LAK cells. However, both drug resistant cell lines were significantly more susceptible to LAK cells than the N417 cell line @ < 0.01, p < 0.01). These results suggest that acquirement of drug-resistance may enhance the expression of surface antigens CD54 or CD58, and that they might play an important role in the interaction with LAK cells and drug- resistant tumor cells.

Lung perfusion and other methods of targeting therapy to lung tumors Johnston MR. 600 Universiry Avenue, Toronto, OnL MSG IXS. Chest Surg Clin North Am. 1995;5: 139-56.

As therapies for cancer and other diseases continue to evolve on a molecular and genetic basis, delivering these sophisticated agents will