EXTENSIVE ADENOCARCINOMA AND LARGE CELL UNDIFFERENTIATED CARCINOMA OF THE LUNG TREATED WITH 5-FU, VINCRISTINE, AND MITOMYCIN-C (FOMI)

  • 1 January 1980
    • journal article
    • research article
    • Vol. 64  (12) , 1241-1245
Abstract
Patients [56] with extensive (52 with TNM [tumor, node, metastasis] stage III M1 disease and 4 with TNM stage III Mo disease) adenocarcinoma (46 patients) and large cell undifferentiated carcinoma (10 patients) of the lung were treated with combination chemotherapy consisting of 5-FU [5-fluorouracil], vincristine and mitomycin C (FOMi). The patients had not received prior chemotherapy. The overall response rate was 41% (23 of 56 patients). Four patients achieved a complete response; 19 achieved a partial response. In 12 patients, the disease was stable. Response did not vary by cell type as follows: adrenocarcinoma, 18 of 43 patients (42%); large cell carcinoma, 4 of 10 (40%); and alveolar cell carcinoma, 1 of 3 (33%). The response varied by initial performance status. For a Karnofsky score of .gtoreq. 70%, 20 of 41 patients (49%) responded; for a Karnofsky score of < 70%, 3 of 15 patients (20%) responded (P = 0.22). Survival was improved for responding patients regardless of initial performance status. The median survival duration was 24 wk for the entire group of patients treated with FOMi. Survival of the responders (complete response plus partial response) was significantly improved over that of patients with progressive disease (28 wk vs. 13 wk, respectively; P = 0.002). The FOMi combination was very well-tolerated. Nausea was common; vomiting occurred in only 4 of 56 patients. Thrombocytopenia, requiring a reduction in the mitomycin C dose, developed after the 3rd treatment course in 14 patients.