A randomized study of two vindesine plus cisplatin-containing regimens with the addition of mitomycin C or ifosfamide in patients with advanced non-small cell lung cancer

Article Abstract:

The effectiveness of combining different chemotherapeutic agents is based, at least in part, on determining which agents can work synergistically. That is, if two agents act upon cancer cells in slightly different ways, combining the agents might kill more cancer cells without increasing the toxic effects of either agent. If one of the chemotherapeutic drugs was administered at a higher dose, the toxic side effects would be increased. Cisplatin (P) has been the mainstay of lung cancer chemotherapy for a decade, and is often used in combination with vindesine (V). However, one report suggested a promising improvement in lung cancer survival when mitomycin C (M) was used in combination with vindesine and cisplatin (MVP). To replicate this observation, and extend it, 110 patients were randomly assigned to receive MVP, or a combination of ifosfamide, vindesine, and cisplatin (IVP). Seven patients could not be evaluated; the data on the remaining 103 patients indicated a response rate of 20 percent in the IVP group, and 26 percent in the MVP group, falling far short of the 60 percent survival rate previously reported for MVP. Survival in the IVP group was a median of 30 weeks; in the MVP group survival was a median of 32 weeks. For those who responded to chemotherapy, the median IVP group survival will be over 96 weeks; it was 45 weeks for the MVP group. The two-year survival rates were 26 percent for the IVP group and 0 percent for MVP; the difference was not statistically significant. These results failed to replicate the reported synergistic advantage of the MVP chemotherapeutic regimen and failed to find any significant difference between ifosfamide and mitomycin C when used in combination with vindesine and cisplatin. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Cancer, Chemotherapy, Combination, Combination chemotherapy, Ifosfamide

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Combination chemotherapy with mitomycin, vindesine, and cisplatin for non-small cell lung cancer: association of antitumor activity with initial tumor burden and treatment center

Article Abstract:

Cisplatin is the drug of choice in the treatment of non-small cell lung cancer. This drug was used in combination with mitomycin and vindesine in the treatment of 205 patients with non-small cell lung cancer; a total of 183 patients could be evaluated and were used to determine which factors correlate best with improved survival. An overall response rate of 41 percent was achieved, consistent with other studies of cisplatin. However, only six patients achieved a complete response. The estimated overall average survival period of the patients was 239 days. Multivariate statistical analysis revealed patients with disease that had spread to additional organs had a poorer response and prognosis. Also, a patient history which included prior treatment with radiation conferred a higher risk of poor response and disease progression. A total of eight treatment centers contributed to this study, and patient prognosis was greatly affected by the center at which the treatment took place. No explanation is available for this observation, which was statistically highly significant. Both the quality of delivering and evaluating the effects of chemotherapy must be carefully examined before this variation may be satisfactorily explained. Although the therapy under study produced many partial responses, it must be primarily considered a treatment that only relieves symptoms, and has considerable side effects, including bone marrow suppression and nausea. Sixteen percent of the patients in the present study refused to continue with chemotherapy due to the side effects. (Consumer Summary produced by Reliance Medical Information, Inc.)

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A Phase II study of Days 1 and 8 cisplatin and recombinant alpha-2B interferon in advanced non-small cell lung cancer

Article Abstract:

Preliminary data have suggested that the addition of alpha interferon to cisplatin might enhance the chemotherapeutic effectiveness of the latter drug in the treatment of advanced non-small cell lung cancer. Researchers, therefore, set out to determine if this theory could be confirmed in a clinical trial. A total of 30 patients were treated with cisplatin and alpha interferon. As a part of the evaluation of response to treatment, the researchers determined the expression of the antigens NSE (neuron-specific enolase) and Leu-7 in the tumor cells. One complete response to chemotherapy was observed, as were three partial responses. This 13 percent response rate is not different from that which would have been achieved with cisplatin alone, and there is therefore no support for the hypothesis that alpha interferon enhances the effectiveness of cisplatin. However, an interesting observation was made concerning the two antigens, NSE and Leu-7. Not all patients were tested for NSE, and just under 75 percent of those tested were positive, while only three patients were identified who were positive for Leu-7. However, all four of the patients who responded to treatment were positive for NSE and two were positive for both NSE and Leu-7. The authors suggest that this observation is worthy of further research. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Interferon, Interferon alpha, Tumor antigens

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