peplomycin and Carcinoma--Non-Small-Cell-Lung

Eighty-six patients with non-small cell lung cancer who underwent curative operations were postoperatively randomized to control and adjuvant chemotherapy groups. In the adjuvant chemotherapy group, patients received cisplatin-based combination chemotherapy 3 or 4 weeks after operation and the average cycle of chemotherapy was 2.3 (from 1 to 6 cycles). In this trial, no evidence of improved survival or delayed recurrence was seen in the treated patients. In multivariate analysis of prognostic variables, the most important factor was the pathological stage of the disease and, second, DNA ploidy of the primary tumor. Although histology (squamous vs. non-squamous cell carcinoma) had a trend to influence the survival, it was not a significant factor. A total of 33 patients had recurrences: 17 and 16 patients were in control and adjuvant chemotherapy groups, respectively. Postrecurrent survival in the adjuvant chemotherapy group was significantly shorter than that in the control group, as determined by the generalized Wilcoxon and log rank tests. Median survival time after recurrence in the control and adjuvant therapy groups was 18.5 and 7.5 months, respectively. These results suggest that DNA ploidy of primary tumors should be considered as a prognostic factor in future trials of adjuvant therapy. Furthermore, analysis of postrecurrent survival in the adjuvant chemotherapy trial, as well as that of overall and disease-free survivals should be done.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Non-Small-Cell Lung; Carcinoma, Squamous Cell; Cisplatin; Combined Modality Therapy; Cyclophosphamide; DNA, Neoplasm; Doxorubicin; Female; Humans; Lung Neoplasms; Male; Middle Aged; Mitomycin; Mitomycins; Neoplasm Recurrence, Local; Neoplasm Staging; Peplomycin; Ploidies; Prognosis; Vindesine

We studied the efficacy of cisplatin-based polychemotherapy for non-small-cell lung cancer. One hundred nineteen patients with adenocarcinoma or large cell carcinoma were randomized to receive cyclophosphamide, adriamycin, cisplatin and mitomycin C (CAPM) or mitomycin C, cytosine arabinoside and tegafur (MCT), and 48 patients with squamous cell carcinoma were randomized to receive cisplatin, adriamycin and peplomycin (PAP) or mitomycin C, cyclophosphamide, tespamine, toyomycin and tegafur (MCTTT). Radiation was given to the chest in patients with stage I-III disease. The response rates were CAPM, 34.5%; MCT, 13.1% (p less than 0.01) and PAP, 63.3%; MCTTT, 42.3%. A significant difference in response rate between the CAPM and MCT regimens was observed only in stage IV patients and not in stage I-III patients. The median survival was 9.5 months in the CAPM arm vs. 6.5 months in the MCT arm (p less than 0.007), and 8.5 months in the PAP arm vs. 6.5 months in the MCTTT arm. Improved median survival for the CAPM regimen was noted only in stage IV patients and not in stage I-III patients when compared to patients given the MCT regimen, respectively. Nausea and vomiting were significantly increased in patients with cisplatin-based polychemotherapy. Myelosuppression was more severe with the CAPM regimen than with the other chemotherapy regimens. We concluded that cisplatin-based polychemotherapy, CAPM and PAP therapy were of more benefit to patients with disseminated non-small-cell lung cancer than MCT and MCTTT therapy.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Bone Marrow; Carcinoma, Bronchogenic; Carcinoma, Non-Small-Cell Lung; Chromomycin A3; Cisplatin; Cyclophosphamide; Doxorubicin; Drug Administration Schedule; Female; Humans; Kidney; Lung Neoplasms; Male; Mitomycin; Mitomycins; Peplomycin

From March 1983 to February 1985, we treated 74 patients (pts) with inoperable non-small cell lung cancer. Twenty-seven pts with squamous cell carcinoma were randomized between regimen PMP (CDDP 60 mg/m2, d 1, MMC 6 mg/m2, d 3, d 10 and PEP 5 mg/m2, d 3-7) and regimen PM (CDDP 60 mg/m2, d 1 and MMC 6 mg/m2, d 3, d 10). Forty-seven pts with adenocarcinoma and large cell carcinoma were randomized between regimen PMF (CDDP 60 mg/m2, d 1, MMC 6 mg/m2, d 3, d 10 and FT 800 mg/body, d 3-21) and regimen PM. The response rates of evaluable cases (EC) were as follows: Squamous cell carcinoma; Regimen PMP 50% (1 CR + 4 PR/10 EC). Regimen PM 40% (4 PR/10 EC). Adenocarcinoma plus large cell carcinoma; Regimen PMF 13.6% (3 PR/22 EC). Regimen PM 11.1% (2 PR/18 EC). The median survival time (MST) was increased from 23 weeks in non-responders to 32 weeks in responders. However, the difference between the survival curves for responders and non-responders was not statistically significant. Of the toxic effects shown in all 74 registered pts, hematological (64.9%), gastrointestinal (60.8%) and renal (31.1%) toxicities were the common complications. We concluded that regimen PMP was more useful than regimen PM for pts with squamous cell carcinoma but that regimen PMF demonstrated no appreciable difference, compared with regimen PM for pts with adenocarcinoma and large cell carcinoma.

Topics: Adenocarcinoma; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Non-Small-Cell Lung; Carcinoma, Squamous Cell; Cisplatin; Female; Humans; Lung Neoplasms; Male; Middle Aged; Mitomycin; Mitomycins; Peplomycin; Random Allocation; Tegafur

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Bronchial Arteries; Carcinoma, Non-Small-Cell Lung; Cisplatin; Combined Modality Therapy; Female; Humans; Infusions, Intra-Arterial; Lung Neoplasms; Male; Middle Aged; Mitomycin; Mitomycins; Peplomycin; Radiotherapy Dosage; Vindesine