VP-16, Cyclophosphamide, Adriamycin and Cis-platinum (V:CAP-I) in Patients with Metastatic Adenocarcinoma of the Lung

VP-16-213 (etoposide): the mandrake root from Issyk-Kul

VP-16-213 (etoposide) is an orally and parenterally active antineoplastic agent synthesized from podophyllum extracts of a common North American plant, the May apple or mandrake. The drug delays and kills cells in the G2 phase of the cell cycle and is active in a variety of animal tumors and leukemias. Major therapeutic activity for the drug has been found in small cell bronchogenic carcinoma, germ cell malignancies, acute non-lymphocytic leukemia, Hodgkin's disease and non-HOdgkin's lymphoma. Minor therapeutic activity of the drug occurs in non-small cell bronchogenic carcinoma, pediatric neoplasms, hepatocellular carcinoma and gastric cancer. Toxicity is primarily hematologic, with alopecia, nausea and vomiting occurring less frequently.

Diamminodichloroplatinum combination chemotherapy in non-oat cell carcinoma of the lung

A comparison is made between four different but similar approaches to the chemotherapy of 250 patients with nonoat cell bronchogenic carcinoma of the lung. Combination chemotherapy, particularly in regimen where platinum is included, provided no significant advantages over single agent chemotherapy. Side effects attributed to platinum tend to distract from any modest therapeutic gains achieved through its use. Responses rates were not significantly increased through use of platinum in the chemotherapy combination reported in this study.

Platinum-based combination chemotherapy in non-small cell lung carcinoma

A series of 35 patients with advanced non-small cell lung cancer were treated with combination chemotherapy consisting of cis-diamminedichloro platinum (II), Adriamycin, 5-fluorouracil, methotrexate and vincristine. The objective response rate was 37.1% and the overall median survival 52.8 weeks. Notable toxicity was infrequent and reversible. Although the investigators have obtained higher response rates with other platinum-based combination chemotherapies, the present regimen appears superior in that other regimens fail to yield superior survival times while consistently inducing more severe toxicity.

Evaluation of response criteria in advanced lung cancer

Because we found it illogical to attempt measurement of nonmeasurable but visible tumors in patients with advanced lung cancer, we devised and used a separate set of response criteria for patients with evaluable, nonmeasurable tumors. Patients with evaluable disease who had obtained a tumor regression after therapy were compared to patients with measurable disease who had obtained a tumor regression according to standard criteria. Among 191 cases evaluated (54% with measurable and 46% with evaluable disease), 59 tumor regressions were found (35 in patients with measurable disease and 24 in patients with evaluable disease). Evaluating regressions in patients with both types of disease, we could not detect statistical differences in regression rates, times to regression, durations of regression or survival. We believe the response criteria used for patients with evaluable, nonmeasurable lung cancer to be valid in assessing response to therapy.