438 Abstracts /Lung Cancer 11 (1994) 423-444

Schedules examined were: day 1 (d I) single administration, d 1, 5, 9 intermittent administration, and d l-5 and d l-9 daily consecutive administration. As a result, a significant increase of the lifespan was firstly demonstrated by d 1-9 schedule. The optimal dose was as low as 6.5 mglkglday (20 mglm’lday, total 180 mg/rnq and no toxicity was observed with respect to the weight loss. Since the concentration and total amount of Cremophor EL (polyoxyethylene castor oil), which is suspectedtobeacausativeagentforhighincidencerateofhypersensitivity reactions by clinical formulation of paclitaxel, inevitably decrease in such a low dose setting, these results should be taken into considerations when exploring the optimal schedule of paclitaxel clinically.

Comparison of two chemotherapeutic regimens - mitomycin + vindesine + cisplatin (MVP) vs. mitomycin + ifosfamide + cisplatin (MIP) - in advanced non-smaB-ceB lung cancer Gonzalez Baron M, Feliu J, Espinosa E, Garcia Giron C, Blanco E, Garrido P et al. Sewicio de Oncologia Medica. Hospital La Paz. Paseo de la CastelLzna, 261, 28046 Madrid. ANI Oncol 1994;5:323-7.

Background: A prospectively randomized trial was performed to comprue the efticacy and toxicity of two chemotherapeutic regimens widely used in advsnced non-sm&cell lung cancer (NSCLC). Parienrs and merho& From January 1989 to March 1992, 1% patients with measurable disease were included in the trial. Ninety-three patients received mitomycin-vindesine-cisphuin (MVP) and 94 mitomycin- ifosfamidecisplatin(MIP). Resutfr: lbeobjectivererponserate(complete plus partial remissions) wss 28% (26/93 patients, 95% confidence interval 20%-40%) in the MVP arm and 30% (28194 patients, 95 46 confidence interval ZO.S%-tO%) in the MIP arm. The median survival was 8.5 and 9 months, respectively. Neither the response rates nor the median survivals were significantly different. Grade III-IV leukopenia wasmorefrequentwithMVP(13%vs.2%ofthecourses,p C O.OOl), as well as grade I-II nwrologic toxicity (30% vs. 646, p < 0.001). In contrast, grade I-II anemia and grade I-II urologic toxicity were more frequent with MIP (7% vs. 2546, p C 0.001 and 1% vs. 11%. respectively). Conclurion:Given the low efficacy of both schemes in the treatment of advanced NSCLC, their use cannot be recommended outside of clinical trials.

Weekly carhoplatin and VM-26 for elderly patients with small-cell lurlg cancer Michel-Reymond G, Leyvraz S, Batter J, Aapro M, St&e1 R, Albert0 P. CR. Pluridisciplinaire d’Oncologie, CHW, 1011 Lausanne. Ann Gncol 1994;5:369-70.

Background: Elderly patients are excluded from chemotherapy trials, WWI though they represent 25% of those with small cell lung cancer. An effective chemotherapy regimen with limited toxicity should be developed with the aim not only of increasing the survival of these patients, butalsoofimprovingtheirquahty oflifeandtheirindependsnce. Patients and me&o& Twenty-four patients with a median age of 72 years and sm&cell lung cancer (SCLC) were included in the trial. Chemotherspyconsistedofaw~klyintravenousregimenofCarboplatin 80mg~m’arrdTeniposide80mg/mradministeredonanoutpatientbasis. Results: Eight patients had limited and 16 extensive disease. After a median of 12 chemotherapy courses (2-3 1) the overall response. rate was 66.7% (95% Cl: 44.7~84.4), with 5 patients in complete and 11 in partial remission. The median overall suwival was 33 weeks, with 4 patients alive at more than one year. Improvement of symptoms occurred in 86% of patients. Toxicity, mainly hematological, was moderate. Conclurionr: Weekly Cnrboplatin and Vhf-26 is an effective and non-toxic regimen for elderly patients, leadiig to results similar to those obtained with a more intensive regimen in a younger age group.

Does at$tvnnt chemotherapy decrease distant metastasis formation in patients with non-small cell lung cancer? Green M.R. University of California, 225 Dickinson Street, San Diego, CA 92103-8421. Lung Cancer (Ireland) 1994;lO:Suppl. l:S187-94.

Disseminated micrometastatic disease limits the effectiveness of even the most aggressive locoregional treatment strategies in patients with early stagenon-small cell lung cancer. One trial of the Lung Cancer Study Group (LCSG) demonstrated a significant decrease in the hazard rate for distant recurrence produced by adjuvant CAP chemotherapy after surgical resection and radiation therapy. French investigators found a significant decrease in distant metastases formation following sequential chemotherapy, radiation, and then additional chemotherapy compared to radiation alone in patients with stage III disease. However, other completed trials are either inconclusive, incompletely analyzed thus far or show no evidence of an effect of adjuvant chemotherapy on distant metastases. Additional data from recently completed or current trials will hopefully clarify the impact of adjuvant chemotherapy on distant micrometastases in patients with potentially curable non-small cell lung cancer (NSCLC).

Chemotherapy dose intensity in small eelI lung cancer Souhami RL, Ruiz De Elvim MC. Depar?ment of Oncology, UCMSM, 91 Riding House Stree?, London WIP 8BT. Lung Cancer (Ireland) 1994;1o:suppl l:S175-85.

The evidence that increasing the dose intensity of chemotherapy in SCLC improves survival is reviewed. The paucity of randomized trials, the failure to report delivered dose and the methodological problems in presenting dose intensity data, mean that at p-t no tirm conclusions can be drawn about potential survival benefit with increasing intensity of treatment. It seems possible that increases in survival can b-s obtained with increased intensity of chemotherapy but the degree is likely to be small and the size of random&d trials must therefore be large.

Treatment evaluation of combined modality therapy: ‘What can we obtain today from phase II trials?’ Thatcher N. CRCDepamnenf of Medical Oncology, Christie Hospital, Wibnslow Road. Manchester M2O 9BX. Lung Cancer (Ireland) 1994;lo:Suppl l:S117-33.

Demonstration of activity is the major goal of Phase II studies. other end pointsduration of response, survival (relapse free in complete responders), progression free interval, changes in performance status and quality of life also provide useful information. From these data a decision to continue or discard a particular therapy can be considered. Various handicaps including variability in response reporting, heterogeneity of patient populations, inadequate reporting of failure patterns, causes ofdeath, perfo-ce status changes and quality of life hinder interpretation of Phase II data. Nevertheless, Phase II studies have defined prognostic groups, beneficial changes in performance status and have helped formulate novel management approaches. Targeting particular prognostic groups, investigating dose- intensive regimens with haemopoietic growth-factor supportandnovel combined- modality approaches have all been generated through Phase II investigations.

Second line treatment (2 LT) in small cell lung EB~KXY (SC) Clerici M. Divisions Oncologia Medica, Ospedale S Carlo Rotromeo, Via Pio II, 3 20153 Milano. Anticancer Res 1994;14:B 337-9.

In spite of the possibility to obtain a high percentage of objective response, the overall median survival for small cell lung cancer patients did not improve substantially in the last 10 yeers. Second line treatment