Surgery following neoadjuvant MPV chemotherapy (mitomycin, cisplatin, vinblastine) in locally advanced (IIIa and IIIb) non-small cell lung cancer

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Abstract
From November 1990 to August 1993, 32 patients with non-small cell lungcancer (NSCLC) entered a multimodality treatment study with neoadjuvantMitomycin, Cisplatin and Vinblastine (MPV), surgery and radiotherapy at theSan Raffaele Hospital in Milan, Italy. Neoadjuvant chemotherapy wasperformed on an outpatient basis. To date 23 patients (11 stage IIIa and 12stage IIIb) have completed the chemotherapy treatment and are available forevaluation of response, toxicity, surgical eligibility and resection rate.The overall major response to MPV chemotherapy was 87%. The overallresection rate after major response to treatment was 60% (90% in stage IIIaand 17% in stage IIIb). After a median follow-up of 21 months (8-31) 17patients are still alive (74%). Ten patients (83%) who had a completeresection are alive after a median follow-up of 23 months (21-30) and eightof them (66%) are in complete pathological remission. No treatment-relatedmortality was observed. The authors conclude that MPV is a highly effectiveneoadjuvant regimen for NSCLC and is feasible on an outpatient basis.Favorable resection rates can be obtained in stage IIIa patients. StageIIIb patients can be downstaged and undergo complete resection. A longerfollow-up is needed to assess the impact of this multimodality approach onlong-term survival and to evaluate the role of adjuvant radiotherapy.

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