title: Initial therapy with cisplatin plus VP-16 in small-cell lung cancer.
abstract: Cisplatin plus VP-16 has become a widely used salvage regimen for CAV (cyclophosphamide, doxorubicin [Adriamycin], and vincristine) failures. However, the major value of this two-drug combination will probably be as an integral part of the initial therapeutic strategy. Cisplatin plus VP-16 has been used as induction therapy in four separate published studies involving 238 patients. The response rates ranged from 71% to 94% and complete remission (CR) rates varied from 30% to 53%. Cisplatin plus VP-16 has also been alternated with CAV in several phase II studies with encouraging results. A Southeastern Cancer Study Group (SECSG) protocol in extensive disease is currently testing this hypothesis in a random prospective study. A recently completed SECSG protocol in limited small-cell lung cancer tested the concept of late intensification with two courses of cisplatin plus VP-16 following six courses of CAV, v six courses of CAV alone. Presently, there is a statistically significant survival advantage for cisplatin plus VP-16.
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018288:Carcinoma, Small Cell / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D011446:Prospective Studies; D011897:Random Allocation; D012074:Remission Induction; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin