Absrructs / Lung Cancer 12 (1995) II3-160

Concerning Grade 2 or 3 nausea and vomiting, good conditions were observed on day 1 (day of treatment), most marked aggravation on day 2, and initiation of improvement on day 4. Vomiting was slight on day 1, most aggravated on day 2, but began to improve on day 3; good results were generally observed thereafter. Decreased appetite was slight oo day 1, but was most aggravated on day 3 and 4; its recovery was delayed even until day 7. In the treatment for delayed emesis, comparison was made among the group treated with granisetron alone who did not require treatment for delayed emesis, the group with delayed emesis treated with granisetron, and the group with delayed emesis treated with drugs other than granisetron. Slightly better results were observed in terms of nausea, vomiting, and the frequency of vomiting in the group treated with granisetron alone on days 2 and 3. However, no significant difference was observed in decreased appetite among the 3 groups. Granisetron had no side effects and was safe. It inhibited vomiting, but measures to improve decrease appetite are needed.

Activity of docctaxel (Taxoterr) in small cell lung cancer Smyth JF. Smith lE, Sessa C, Schoffski P, Wanders J, Franklin H et al. Univ. Department Clinical Oncology Western Generai Hospital, Edinburgh EX4 2XU Eur I Cancer Part A Gen Top 1994;30:1058&0 Docetaxel (Taxoterc) is a new cytotoxic compound with a broad spectrum of activity in preclinical studies. This paper reports a phase II trial in patients with previously-treated small cell carcinoma of the lung. 34 patients received 100 rig/m’ of doaztaxel in an intravenous infusion given over I h every 21 days. Seven partial responses were reported (25% of 28 evaltile patients). Duration of response was 3.5-12.6 months. Toxocities were predominantly neutropenia, alopecia and asthenia. Docetaxel is a new compound with activity in previously- mated patients with small cell lung cancer, and is suitable for evaluation in combination with other cytotoxic drugs active in this disease.

Platinum-based chemotherapy in non-small cell lung cancer: The experience of the European Organization for the Reseamb and Treatment of Cancer Van Zandwijk N, Dalesio 0. Department of Pulmonary Oncology, Netherlands Cancer Institute. Antoni van Leeuwenhoek Huis. Plesmaniaan 121, 1066 CXAmsterdam. Semin Oncol 1994;21:Suppl 6:66-71. The history of chemotherapy for non-small cell lung carcinoma is one of very slow progress. Consequently, the categories of patients who will ultimately benefit from this modality are still debated. Recent European Organization for Research and Treatment of Cancer studies show that there is less concern about the importance of platinum as an ingredient of combination regimens or as an adjunct to radiotherapy. The presence of cisplatin is related to better response and smvival in patients with locoregional and distant me&static disease.

Small cell lung cancer in the elderly Byrne A, Carney DN. Department of Medical Oncology, Mater Misericordiae Hospital, Eccles St, Dublin 7. Semin Oncol 1994;21:Suppl 6:43-8 Mortality rates for patients with lung cancer remain high, despite advances both in our understanding of lung cancer biology and in smvivd statistics for other types of cancer. Important strategies for improving the figures for lung cancer are identification of subgroups at highest risk for the disease and targeting high-intensity therapy to patients with the greatest chance for cure. In this context, special attention must be given to the elderly population, which accounts for

approximately 60% of all cancer cases. Recognizing that close to 13% of the population of the United States can be considered elderly and that this figure is expected to more than double over the next 40 years, the elderly cohort clearly has a significant impact on cancer statistics in general. While approximately 26% of lung cancer patients are potentialIy curable, the 74% majority has only a remote chance of being cured of their disease. More active therapeutic modalities, with a meaningful effect on survival and quality of life but with more acceptable toxicity than intensive therapy designed for patients with a good chance of cure, are clearly needed for these patients. Several studies have demonstrated that use of oral active agents such as etoposide, alone or in combination with other agents, produce an overall response rate and median survival time similar to those of the more intensive schedules. Once further studies clarify the optimum schedule for use of oral etoposide, it is hoped that its use in combination with other therapeutic agents and/or with radiation therapy will improve the overall response and survival rates among patients at high risk or with poor prognostic factors, such as the elderly.

Etoposidelvincristioe-based chemotherapy with or without carboplatin in extensive-stage small cell lung cancer: A prospective randomized phase III trial Gatzemeier U, Pawel JV, Laumen R, Hossfeld DK, Neuhauss R. Department of Thoracic Oncology, PneumologyRhoracic Surgery CenteK Grosshansdorf Hospital, D 2070 Gmsshansdorf/Hambutg Semin Oncol 1994;21:Suppl6:31-5. In the treatment of small cell lung cancer, carboplatin/etoposide/ vincristine (CEV) is one of the most active regimens. In contrast, the etoposidelvincristine (EV) combination also has produced acceptable results in patients with extensive disease. To evaluate the efflcaicacy and survival of patients treated with EV in comparison to those treated with more intensive CEV chemotherapy, a prospective, randomized, phase III trial was performed. The protocol for the treatment groups was as follows: treatment A (156 patients): carboplatin 300 mg/mz day I, etoposide 140 mplm2 days 1 through 3, and vincristine 1.4 mg/m2 days 1.8, and 15; and treatment B (16 1 patients): etoposide 200 mg/m’ days 1 through 3 and vincristine 1.4 mp/m’ days 1 and 8. Chemotherapy cycles in each treatment arm were repeated every 4 weeks. Doses were reduced by 20% when hematologic or nonhematologic toxicity (grade 4) occurred. In all, 317 evaluable patients were treated. The overall response rate for patients treated with CEV was 79.8% compared with 59.8% for those treated with EV (P < ,001). The median length of survival was 10 months for CEV-treated patients compared with 9 months for EV-treated patients (P = .19). Based on long-term survival rates, there was an advantage for the CEV-treated patients if they had good performance status, were younger than 60 years, had no distant metastases, and achieved a complete response to first-line therapy. We conclude that patients with poor prognostic factors (ie, poor performance status, multiple distant metastases, and less than partial response to the first cycle of chemotherapy) should appropriately be treated with the less aggressive two- drug combination chemotherapy. On the other hand, patients with good prognostic factors should be treated as aggressively as possible, and they will benefit from the more aggressive induction chemotherapy.

Cisplatin/etoposide versus carboplatinktoposide chemotherapy and irradiation in small cell lung cancer: A randomized phase III study Kosmidis PA, Samantas E, Fountzilas G, Pavlidis N, Apostolopoulou F. Skarlos D. Department of Medical Oncologv. Metaxa Cancer Hospital, Botassi 51, Piraeus. Semin Oncol 1994;21:Suppl6:23-30. The efficacy and toxicity of cisplatin/&poside and carboplatinletoposide combinations along with thoracic irradiation were pmspectively assessed