CYCLIC ALTERNATING COMBINATION CHEMOTHERAPY FOR SMALL CELL BRONCHOGENIC CARCINOMA

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  • 1 January 1979
    • journal article
    • research article
    • Vol. 63  (2) , 163-170
Abstract
Protocol-eligible patients (61) with small cell bronchogenic carcinoma received cyclic alternating combination chemotherapy with 2 or 3 non-crossresistant drug combinations. No chest or prophylactic brain radiation therapy was used. At 28 mo. after starting treatment, disease-free survival was 23% for patients achieving a complete response (CR) and 13% overall. Initial treatment consisted of high dose cyclophosphamide, methotrexate and CCNU [1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea] (CMC) for 6 wk. Patients then received vincristine, adriamycin and procarbazine (VAP) fo 6 wk. The addition of VAP increased the CR rate from 42% to 74% in limited-disease patients and from 24% to 36% in extensive-disease patients. Half of the patients were randomized to a 3rd combination of VP-16-213 [4''-demethylepipodophyllotoxin-.beta.-D-ethylidene] and ifosfamide. These patients were cycled at 6 wk intervals through the 3 drug regimens while the remaining patients were cycled between CMC and VAP. The addition of VP-16-213 and ifosfamide did not increase the CR rate or prolong survival. Only complete responders survived beyond 24 mo. Sequential use of non-cross-resistant drug combinations represents 1 method for increasing the CR rate.